By combining AI research, global data collaboration and implementation science, Children’s National and its global partners aim to create a path for RHD screening and prevention programs that are more sustainable, more scalable and more responsive to the needs of endemic countries.
Children’s National is helping lead a global effort to make earlier detection of rheumatic heart disease (RHD) more accessible in countries where the preventable condition remains a major cause of illness and death among children and young adults. A 2026 Clinical Medicine analysis from 1990 to 2021 reported more than 54 million global RHD cases and in 2021 and more than 373,000 deaths.
The work funded by the American Heart Association and Leducq Foundation brings together two related initiatives led by Children’s National that are focused on artificial intelligence (AI), echocardiography and implementation in RHD-endemic countries. Together, the projects aim to improve how health systems screen for RHD, interpret echocardiograms, connect patients to care and prevent disease progression.
Why it matters
RHD develops after untreated strep infections trigger acute rheumatic fever, which can damage the heart valves. The disease is largely preventable if identified before it becomes symptomatic, but early RHD is often silent, and many patients are diagnosed only after the disease has advanced and treatment options become more limited.
Echocardiographic screening can identify RHD earlier, when antibiotic prophylaxis can help prevent additional strep infections and slow or stop disease progression. But scaling screening programs in low-resource settings remains difficult because expert interpretation is limited, training programs can be costly and diagnostic accuracy among non-physician screeners may vary.
Children’s National scientists are helping address that challenge through Rapid AI-assisted Echocardiography Detection and Analysis of Rheumatic Heart Disease (RADAR), an AI model designed to support RHD detection from handheld ultrasound images. The goal is to help bring reliable, point-of-care screening closer to communities where access to pediatric cardiology expertise may be limited.
“Rheumatic heart disease is largely preventable with readily accessible antibiotics, yet too many children and young adults are diagnosed only after the disease has already caused serious damage,” said Marius George Linguraru, DPhil, MA, MSc, director of the Division of AI Research at Children’s National. “By advancing AI-supported cardiac diagnosis with partners in endemic countries, we have an opportunity to bring earlier detection closer to the communities that need it most and help build scalable models of care that can protect children from dangerous heart complications.”
Advancing AI in RHD-endemic countries
The broader Strategic Hub for Interventions to Promote Early Detection and Lifelong Protection from Advanced RHD (SHIELD) initiative funded by the American Heart Association builds on this technology-focused work by testing strategies to make early detection and prevention practical in real-world health systems. SHIELD will evaluate AI-supported echocardiographic screening, registry-based care and community-based support for long-term prophylaxis adherence in countries including Uganda, Brazil and Timor-Leste.
SHIELD is complemented by an initiative funded by the Leducq Foundation to support the continued development of RADAR and a global network of partners who can contribute diverse echocardiogram data from RHD screening activities. Expanding the data used to train and refine the AI model will help ensure it performs across countries, ultrasound devices, image acquisition protocols and health worker skill levels.
“Our role is to ensure that advances in AI-supported cardiovascular diagnosis move beyond the lab and into the hands of clinicians and health workers in the places where these tools can have the greatest impact,” Dr. Linguraru added. “Through this work, Children’s National is helping translate innovation into practical tools that can expand access to earlier heart disease detection around the world.”
By combining AI research, global data collaboration and implementation science, Children’s National and its global partners, including Oschner Health, Cincinnati Children’s Hospital and Uganda Heart Institute, aim to create a path for RHD screening and prevention programs that are more sustainable, more scalable and more responsive to the needs of endemic countries.
“This is not just about building an algorithm,” Dr. Linguraru said. “It is about building the evidence, partnerships and infrastructure needed to make earlier diagnosis possible for children who otherwise may not have access to specialized cardiac care.”
Participants from Children’s National include Pooneh Roshanitabrizi, PhD, and Rachel Sarnacki, MBA; Craig Sable, MD, at Ochsner Health; Kelsey Brown, MD, at Vanderbilt University Medical Center; and Andrea Beaton, MD, at Cincinnati Children’s.
These two new awards expand our work and build on the initial funding provided by Coefficient Giving.