Arterial biomarkers in the evaluation, management and prognosis of aortic stenosis. (September 2021)

• Record Type: Journal Article
• Authors: Gardikioti, Vasiliki; Terentes-Printzios, Dimitrios; Iliopoulos, Dimitrios; Aznaouridis, Konstantinos; Sigala, Evangelia; Tsioufis, Konstantinos; Vlachopoulos, Charalambos
• Is Part Of: Atherosclerosis. Volume 332(2022)
• Page Start: 1
• Page End: 15
• Publication Date: 2021-09
• Subjects: Aortic valve stenosis -- Arterial stiffness -- Arterial biomarkers -- Pulse wave velocity -- Arterial compliance; Arteriosclerosis -- Periodicals; Electronic journals; 616.136
• DOI: 10.1016/j.atherosclerosis.2021.07.006
• Languages: English
• ISSNs: 0021-9150

Abstract

Abstract: Degenerative aortic valve stenosis is the most common primary valve disease and a significant cause of cardiovascular morbidity and mortality. In an era when new techniques for the management of aortic stenosis are gaining ground, the understanding of this disease is more important than ever to optimize treatment. So far, the focus has been placed on the assessment of the valve itself. However, the role that the arterial system plays in the pathogenesis and natural history of the disease needs to be further elucidated. Arteriosclerosis, when it coexists with a stenotic valve, augments the load posed on the left ventricle contributing to greater impairment of cardiovascular function. Arterial stiffness, a well-established predictor for cardiovascular disease and all-cause mortality, could play a role in the prognosis and quality of life of this population. Several studies using a variety of indices to assess arterial stiffness have tried to address the potential utility of arterial function assessment in the case of aortic stenosis. Importantly, reliable data identify a prognostic role of arterial biomarkers in aortic stenosis and stress their possible use to optimize timing and method of treatment. This review aims at summarizing the existing knowledge on the interplay between the heart and the vessels in the presence of degenerative aortic stenosis, prior, upon and after interventional management. Further, it discusses the evidence supporting the potential clinical application of arterial biomarkers for the assessment of progression, severity, management and prognosis of aortic stenosis. Graphical abstract: Image 1 Highlights: The interplay between AVS and functional arterial alteration is a significant element of the pathophysiology of AVS. The correlation of pressure-dependent functional indices with the presence and severity of AVS is not well established. Arterial stiffness increases after surgical and transcatheter procedures to treat AVS. Arterial biomarkers exhibit a prognostic role for patients with AVS prior to and after treatment interventions.