Heart valve with glowing biomarkers illustrating inflammation in aortic stenosis.

Decoding Aortic Stenosis: How Inflammation is Reshaping Heart Health

Avery Sinclair in Health & Wellness December 2025 • 4 min read.

"New research highlights the critical role of inflammatory biomarkers in aortic stenosis, offering hope for better diagnosis and treatment."

Aortic stenosis (AS), a common heart valve disease, affects many, especially in Western countries. Over the last two decades, transcatheter aortic valve replacement (TAVR) has revolutionized how we manage this condition, offering a less invasive option for high-risk patients. But while TAVR has improved outcomes, our understanding of the underlying causes and progression of aortic stenosis remains incomplete.

This gap in knowledge highlights the need for better ways to predict and manage AS. Researchers have been actively searching for biomarkers—measurable substances in the body—that can help predict the course of the disease and identify those at higher risk. This is particularly important because, like vascular atherosclerosis, chronic inflammation appears to play a significant role in AS.

Although much is known about the role of biomarkers and inflammation in atherosclerosis, fewer studies have explored their involvement in AS. Left ventricular hypertrophy (LVH), or the thickening of the heart muscle, is a major risk factor for cardiovascular events in AS patients. However, the severity of AS only partly explains the degree of LVH, suggesting that inflammatory cytokines and growth factors may also be involved in heart remodeling.

What's the Link Between Inflammation and Aortic Stenosis?

Heart valve with glowing biomarkers illustrating inflammation in aortic stenosis.

In the International Journal of Cardiology, Kim and colleagues presented a thorough investigation into the role of circulating inflammatory markers in AS patients undergoing TAVR. The study measured serum levels of various cytokines and active molecules in a large group of AS patients, linking them to demographic, echocardiographic, and left ventricular remodeling-related parameters following TAVR.

The study revealed that many patients with AS had normal left ventricular ejection fraction (LVEF) but showed abnormal global longitudinal strain (GLS), diastolic dysfunction, and increased left ventricular mass index (LVMI). Cytokine analysis showed distinct patterns, with some molecules associated with increased LVMI and others with decreased GLS.

Hepatocyte Growth Factor (HGF): Higher baseline LVMI was strongly associated with HGF. Elevated HGF levels were also linked to lower GLS values.
Vascular Endothelial Growth Factor (VEGF)-D: Reduction in GLS was strongly associated with VEGF-D levels.
These findings highlight the significant impact of 'canonical' growth factors on how heart muscle cells respond to stress.

The researchers assessed left ventricular structure and function one year post-TAVR. While most patients saw a reduction in transaortic gradient and an increase in aortic valve area, only a third experienced a reduction in LVMI. Approximately 50% showed improvement in GLS, suggesting that LV structural changes require more time after TAVR. Biomarkers that could predict ventricular recovery post-TAVR could significantly improve disease management.

Future Directions: Integrating Biomarkers into AS Management

Kim et al.’s study provides an extensive overview of inflammatory cytokines linked to LV function and recovery after TAVR, offering potential clinical biomarkers for AS. This research opens doors for further investigation into additional molecules, such as extracellular matrix remodeling products or factors involved in mineral metabolism, to fully understand the chronic inflammatory state in AS. Additionally, the study highlights the sex-specific differences in LV remodeling in response to pressure overload, indicating an exciting area for future research to identify sex-specific circulatory biomarkers that can track AS progression and predict prognosis after TAVR.

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Everything You Need To Know

What is the significance of biomarkers in understanding and managing Aortic Stenosis (AS)?

Biomarkers are crucial in understanding and managing Aortic Stenosis (AS) because they serve as measurable indicators within the body that can predict the disease's progression and identify high-risk individuals. The research by Kim and colleagues focused on circulating inflammatory markers to provide potential clinical biomarkers for AS. Specifically, the study linked specific cytokines to various parameters, such as left ventricular mass index (LVMI) and global longitudinal strain (GLS). This is vital because it helps in personalized treatment strategies, and offers an opportunity to predict how the heart will respond to procedures such as Transcatheter Aortic Valve Replacement (TAVR).

How does inflammation impact Aortic Stenosis (AS), and what specific inflammatory markers are mentioned?

Inflammation plays a significant role in Aortic Stenosis (AS) by contributing to the progression and remodeling of the heart. The research reveals that chronic inflammation is a key factor, similar to its role in vascular atherosclerosis. Specific inflammatory markers, like Hepatocyte Growth Factor (HGF) and Vascular Endothelial Growth Factor (VEGF)-D, are mentioned. Higher levels of HGF were associated with increased left ventricular mass index (LVMI) and lower global longitudinal strain (GLS), while elevated VEGF-D levels were strongly linked to reduced GLS. These markers highlight how inflammatory cytokines and growth factors influence heart muscle response to stress.

What role does Transcatheter Aortic Valve Replacement (TAVR) play in Aortic Stenosis (AS), and what are the implications of the study's findings related to this treatment?

Transcatheter Aortic Valve Replacement (TAVR) has revolutionized the management of Aortic Stenosis (AS) by offering a less invasive option, particularly for high-risk patients. Kim and colleagues' study assessed patients post-TAVR and found that, although there was a reduction in transaortic gradient and an increase in aortic valve area, only a third of patients experienced a reduction in left ventricular mass index (LVMI). Approximately 50% showed improvement in global longitudinal strain (GLS), indicating that left ventricular structural changes may require more time. The study implies that identifying biomarkers that predict ventricular recovery after TAVR could significantly improve disease management and treatment outcomes.

How are Hepatocyte Growth Factor (HGF) and Vascular Endothelial Growth Factor (VEGF)-D linked to heart remodeling in Aortic Stenosis (AS) patients?

Hepatocyte Growth Factor (HGF) and Vascular Endothelial Growth Factor (VEGF)-D are linked to heart remodeling in Aortic Stenosis (AS) patients by influencing the structure and function of the left ventricle. Higher levels of HGF were strongly associated with increased left ventricular mass index (LVMI) and lower global longitudinal strain (GLS), indicating an adverse effect on heart muscle. Elevated VEGF-D levels were also strongly linked to reduced GLS, suggesting that these growth factors impact how heart muscle cells respond to stress and contribute to the progression of AS by influencing the heart's ability to contract and relax effectively.

What are the future directions for research in Aortic Stenosis (AS) management, based on the current findings?

Future research directions for Aortic Stenosis (AS) management, based on the current findings, include further investigation into additional molecules, such as extracellular matrix remodeling products and factors involved in mineral metabolism, to fully understand the chronic inflammatory state in AS. Another key area for future research is the identification of sex-specific circulatory biomarkers that can track AS progression and predict prognosis after Transcatheter Aortic Valve Replacement (TAVR). The study also suggests the need to incorporate biomarkers into clinical practice to improve disease management. This will involve a deeper understanding of how inflammation impacts heart health, to facilitate personalized treatments and improve patient outcomes.