# The Sound of Death: Deep Learning Reveals Vascular Damage from Carotid Ultrasound

arXiv: https://arxiv.org/abs/2602.17321 · HTML: https://mlsanity.com/paper/2602.17321/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 4 of its 22 references that are in the map.
- First posted on arXiv 19 Feb 2026.

## Builds on (most cited first, 4 of 4)

- [Is Space-Time Attention All You Need for Video Understanding?](https://mlsanity.com/paper/2102.05095/) (2021)
- [ViViT: A Video Vision Transformer](https://mlsanity.com/paper/2103.15691/) (2021)
- [VideoMAE: Masked Autoencoders are Data-Efficient Learners for Self-Supervised Video Pre-Training](https://mlsanity.com/paper/2203.12602/) (2022)
- [LD-ViCE: Latent Diffusion Model for Video Counterfactual Explanations](https://mlsanity.com/paper/2509.08422/) (2025)

## Abstract (arXiv)

Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide, yet early risk detection is often limited by available diagnostics. Carotid ultrasound, a non-invasive and widely accessible modality, encodes rich structural and hemodynamic information that is largely untapped. Here, we present a machine learning (ML) framework that extracts clinically meaningful representations of vascular damage (VD) from carotid ultrasound videos, using hypertension as a weak proxy label. The model learns robust features that are biologically plausible, interpretable, and strongly associated with established cardiovascular risk factors, comorbidities, and laboratory measures. High VD stratifies individuals for myocardial infarction, cardiac death, and all-cause mortality, matching or outperforming conventional risk models such as SCORE2. Explainable AI analyses reveal that the model relies on vessel morphology and perivascular tissue characteristics, uncovering novel functional and anatomical signatures of vascular damage. This work demonstrates that routine carotid ultrasound contains far more prognostic information than previously recognized. Our approach provides a scalable, non-invasive, and cost-effective tool for population-wide cardiovascular risk assessment, enabling earlier and more personalized prevention strategies without reliance on laboratory tests or complex clinical inputs.