# Echo-E3Net: Efficient Endocardial Spatio-Temporal Network for Ejection Fraction Estimation

arXiv: https://arxiv.org/abs/2503.17543 · HTML: https://mlsanity.com/paper/2503.17543/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 14 of its 27 references that are in the map.
- First posted on arXiv 21 Mar 2025.

## Builds on (most cited first, 14 of 14)

- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Ultrasound Video Transformers for Cardiac Ejection Fraction Estimation](https://mlsanity.com/paper/2107.00977/) (2021)
- [EchoGNN: Explainable Ejection Fraction Estimation with Graph Neural Networks](https://mlsanity.com/paper/2208.14003/) (2022)
- [EchoCoTr: Estimation of the Left Ventricular Ejection Fraction from Spatiotemporal Echocardiography](https://mlsanity.com/paper/2209.04242/) (2022)
- [Light-weight spatio-temporal graphs for segmentation and ejection fraction prediction in cardiac ultrasound](https://mlsanity.com/paper/2207.02549/) (2022)
- [Cyclical Self-Supervision for Semi-Supervised Ejection Fraction Prediction from Echocardiogram Videos](https://mlsanity.com/paper/2210.11291/) (2022)
- [CardiacNet: Learning to Reconstruct Abnormalities for Cardiac Disease Assessment from Echocardiogram Videos](https://mlsanity.com/paper/2410.20769/) (2024)
- [GEMTrans: A General, Echocardiography-based, Multi-Level Transformer Framework for Cardiovascular Diagnosis](https://mlsanity.com/paper/2308.13217/) (2023)
- [CoReEcho: Continuous Representation Learning for 2D+time Echocardiography Analysis](https://mlsanity.com/paper/2403.10164/) (2024)
- [SA2-Net: Scale-aware Attention Network for Microscopic Image Segmentation](https://mlsanity.com/paper/2309.16661/) (2023)
- [Enhancing Efficiency in Vision Transformer Networks: Design Techniques and Insights](https://mlsanity.com/paper/2403.19882/) (2024)
- [LHU-Net: a Lean Hybrid U-Net for Cost-efficient, High-performance Volumetric Segmentation](https://mlsanity.com/paper/2404.05102/) (2024)
- [Lightweight and Interpretable Left Ventricular Ejection Fraction Estimation using Mobile U-Net](https://mlsanity.com/paper/2304.07951/) (2023)
- [EchoNarrator: Generating natural text explanations for ejection fraction predictions](https://mlsanity.com/paper/2410.23744/) (2024)

## Abstract (arXiv)

Left ventricular ejection fraction (LVEF) is a primary marker of cardiac function. However, routine estimation from endocardial measurements requires manual delineation at end-diastole (ED) and end-systole (ES), a process that is time-consuming and subject to inter-observer variability. Reliable automation is especially valuable for point-of-care ultrasound (POCUS), where computational resources are limited and acquisition quality varies. We propose Echo-E3Net, an anatomy-guided spatio-temporal network that explicitly embeds cardiac anatomy into LVEF prediction. A dual-phase Endocardial Border Detector (E2CBD) uses phase-specific cross-attention to localize ED/ES endocardial landmarks and produce phase-aware landmark embeddings, while an Endocardial Feature Aggregator (E2FA) fuses these embeddings with global statistical descriptors of deep feature maps to refine EF regression. Training is guided by a lightweight geometric loss that uses ED and ES endocardial landmarks to regularize EF prediction. On EchoNet-Dynamic and a PSAX subset of EchoNet-Pediatric, Echo-E3Net attains competitive performance using only 1.55M parameters and 8.05 GFLOPs, an order-of-magnitude compute reduction versus recent baselines, supporting real-time deployment. Our code is publicly available at https://github.com/moeinheidari7829/Echo-E3Net.