Artificial Intelligence and Digital Technology in Cardiovascular Imaging: A Narrative Review

The rapid expansion of digital technologies and artificial intelligence (AI) has profoundly transformed cardiovascular imaging, enabling more precise, efficient, and reproducible assessment of cardiac structure and function. This narrative review summarizes recent advances in AI-driven methods across echocardiography, cardiac computed tomography, cardiac magnetic resonance, and nuclear imaging, with emphasis on image acquisition, automated quantification, and diagnostic and prognostic interpretation. We reviewed contemporary literature describing machine-learning and deep-learning applications for image reconstruction, segmentation, radiomics, and multimodal data integration. Current evidence demonstrates that AI improves image quality, reduces acquisition and analysis time, and enables automated, highly reproducible measurements of chamber volumes, function, tissue characterization, coronary anatomy, and myocardial perfusion, while facilitating advanced pattern recognition for differential diagnosis and risk stratification. Furthermore, digital platforms support remote acquisition, tele-echocardiography, and AI-assisted training of non-expert operators. Despite these advances, challenges remain regarding external validation, generalizability across vendors and populations, explainability, data governance, and regulatory compliance. In conclusion, AI and digital technologies are reshaping cardiovascular imaging by enhancing accuracy, efficiency, and accessibility, but their safe and effective clinical integration requires robust multicenter validation, transparent reporting, and ethical-legal frameworks that ensure trust, equity, and accountability.