Learning from Scarce Labels: Multi-View Echocardiography for Ejection Fraction Prediction

Zhiyuan Gao1, Dominic Yurk2, Yaser S. Abu-Mostafa1
1: Electrical Engineering Department, California Institute of Technology, Pasadena, CA 91125, USA, 2: Asari AI, San Francisco, CA 94131, USA
Publication date: 2026/08/27
https://doi.org/10.59275/j.melba.2026-8194
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Abstract

We present, to the best of our knowledge, the first publicly available resource for predicting left ventricular ejection fraction (EF) from parasternal long-axis (PLAX) echocardiography. Because no PLAX–EF datasets previously existed, our work focuses on an innovative data generation strategy to overcome this scarcity. By leveraging a time-based correlation between clinical notes and echocardiographic videos, combined with fine-tuning view classifiers and proxy labeling, we created a labeled dataset of over 25,000 PLAX videos. This enables us to train the first reproducible PLAX EF model, achieving a mean absolute error (MAE) of 6.86%. Given that apical four-chamber (A4C) methods, the clinical standard, report MAE values of 6%-7%, our results demonstrate that EF estimation from PLAX views is both feasible and clinically relevant. This surpasses the performance of existing methods and provides a clinically relevant solution for situations where apical views may not be feasible. Going further, we demonstrate that combining PLAX and A4C predictions via simple unweighted late fusion improves both single-view baselines to a 6.37% MAE, underscoring the value of multi-view integration. To promote continued research, we release the dataset labels, trained models, and runnable demos on GitHub, Hugging Face, and Google Colab: https://github.com/Jeffrey4899/PLAX_EF_Labels_202509

Keywords

Apical four-chamber (A4C) · Echocardiography · Ejection fraction · Multi-view fusion · Parasternal Long-Axis (PLAX) · Proxy labeling · Scarce data · Video view classification

Bibtex @article{melba:2026:025:gao, title = "Learning from Scarce Labels: Multi-View Echocardiography for Ejection Fraction Prediction", author = "Gao, Zhiyuan and Yurk, Dominic and Abu-Mostafa, Yaser S.", journal = "Machine Learning for Biomedical Imaging", volume = "2026", issue = "MIDL 2025 special issue", year = "2026", pages = "508--527", issn = "2766-905X", doi = "https://doi.org/10.59275/j.melba.2026-8194", url = "https://melba-journal.org/2026:025" }
RISTY - JOUR AU - Gao, Zhiyuan AU - Yurk, Dominic AU - Abu-Mostafa, Yaser S. PY - 2026 TI - Learning from Scarce Labels: Multi-View Echocardiography for Ejection Fraction Prediction T2 - Machine Learning for Biomedical Imaging VL - 2026 IS - MIDL 2025 special issue SP - 508 EP - 527 SN - 2766-905X DO - https://doi.org/10.59275/j.melba.2026-8194 UR - https://melba-journal.org/2026:025 ER -

2026:025 cover