We propose a novel pipeline for the generation of synthetic images via Denoising Diffusion Probabilistic Models (DDPMs) guided by cardiac ultrasound semantic label maps. We show that these synthetic images can serve as a viable substitute for real data in the training of deep-learning models for medical image analysis tasks such as image segmentation. To demonstrate the effectiveness of this approach, we generated synthetic 2D echocardiography images and trained a neural network for segmentation of the left ventricle and left atrium. The performance of the network trained on exclusively synthetic images was evaluated on an unseen dataset of real images and yielded mean Dice scores of 88.5 $\pm 6.0$ , 92.3 $\pm 3.9$, 86.3 $\pm 10.7$ \% for left ventricular endocardial, epicardial and left atrial segmentation respectively. This represents an increase of $9.09$, $3.7$ and $15.0$ \% in Dice scores compared to the previous state-of-the-art. The proposed pipeline has the potential for application to a wide range of other tasks across various medical imaging modalities.
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