Novel Biomarkers and Advanced Cardiac Imaging in Aortic Stenosis: Old and New

Overview

Journal Biomolecules

Publisher MDPI

Specialties Biochemistry
Molecular Biology

Date 2023 Nov 25

PMID 38002343

Authors

Anca Dragan

Anca Doina Mateescu

Affiliations

Soon will be listed here.

Abstract

Currently, the symptomatic status and left ventricular ejection fraction (LVEF) play a crucial role in aortic stenosis (AS) assessment. However, the symptoms are often subjective, and LVEF is not a sensitive marker of left ventricle (LV) decompensation. Over the past years, the cardiac structure and function research on AS has increased due to advanced imaging modalities and potential therapies. New imaging parameters emerged as predictors of disease progression in AS. LV global longitudinal strain has proved useful for risk stratification in asymptomatic severe AS patients with preserved LVEF. The assessment of myocardial fibrosis by cardiac magnetic resonance is the most studied application and offers prognostic information on AS. Moreover, the usage of biomarkers in AS as objective measures of LV decompensation has recently gained more interest. The present review focuses on the transition from compensatory LV hypertrophy (H) to LV dysfunction and the biomarkers associated with myocardial wall stress, fibrosis, and myocyte death. Moreover, we discuss the potential impact of non-invasive imaging parameters for optimizing the timing of aortic valve replacement and provide insight into novel biomarkers for possible prognostic use in AS. However, data from randomized clinical trials are necessary to define their utility in daily practice.

Citing Articles

Shaping the Optimal Timing for Treatment of Isolated Asymptomatic Severe Aortic Stenosis with Preserved Left Ventricular Ejection Fraction: The Role of Non-Invasive Diagnostics Focused on Strain Echocardiography and Future Perspectives.

DellAngela L, Nicolosi G J Imaging. 2025; 11(2).

PMID: 39997550 PMC: 11856064. DOI: 10.3390/jimaging11020048.

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