Evaluating Arterial Stiffness in Aortic Stenosis

In an ageing population, degenerative aortic stenosis (AS) and elevated arterial stiffness frequently coexist, imposing a combined valvular and pulsatile arterial afterload on the left ventricle (LV). Since the significance of arterial stiffness in the setting of AS is becoming increasingly recognised, there is greater emphasis on accurately evaluating this pulsatile LV load in the presence of severe AS and predicting the arterial response post transcatheter aortic valve replacement (TAVR). To date, studies examining arterial stiffness in AS following TAVR have yielded conflicting results. This review aims to comprehensively evaluate measures of arterial stiffness and pulsatile LV load in the presence of AS. We summarise existing evidence on the interplay between AS and arterial stiffness while identifying current gaps in our understanding of this interaction. Future studies to validate a non-invasive index for pulsatile arterial load in AS may prove instrumental in pre-TAVR risk assessment.