Aortic Stenosis: Pathophysiological Mechanism, Multimodality Imaging, and Contemporary Treatment

Dear Colleagues, 

Aortic stenosis is the most common acquired valvular disease in developed nations and a major cause of morbidity and mortality worldwide. Once viewed primarily as a passive, degenerative process, AS is now understood as an active disease process driven by inflammation, calcification, and fibrosis, with significant impact on left ventricular remodeling and systemic health. The last two decades have seen transformative advances in both the diagnostic and therapeutic landscapes. Echocardiography remains the cornerstone of diagnosis, while cardiac CT and cardiac MRI have expanded the possibilities for risk stratification, structural assessment, and treatment planning. On the therapeutic side, surgical aortic valve replacement (SAVR) has been complemented by transcatheter aortic valve replacement (TAVR), which has significantly expanded treatment eligibility to a broader spectrum of patients.

This Special Issue aims to gather cutting-edge research and expert reviews that address the evolving landscape of AS, spanning from mechanistic insights to clinical applications. The scope includes, but is not limited to, advances in disease pathophysiology, innovations in multimodality imaging, prognostic modeling, patient selection for intervention, and contemporary management strategies. By bridging basic science, translational research, and clinical practice, this collection seeks to provide a comprehensive overview of where the field stands today and where it is heading.

Recent studies have highlighted the role of imaging biomarkers in predicting disease progression, the long-term outcomes of TAVR versus SAVR in diverse populations, and the durability of transcatheter valves. Advances in 3D and 4D imaging, machine learning-based risk prediction, and the integration of multimodal diagnostic approaches are reshaping how clinicians diagnose and treat AS. Moreover, research into the molecular and cellular mechanisms underlying valve calcification and fibrosis is opening avenues for potential pharmacological interventions.

We invite submissions of original research articles, clinical trials, translational studies, and state-of-the-art reviews related to all aspects of AS. Topics of interest include the following:

• Pathophysiological and molecular mechanisms of AS progression;
• Advances in echocardiography, cardiac CT, and cardiac MRI for diagnosis and prognosis;
• Development and validation of risk-stratification models;
• Comparative outcomes of SAVR and TAVR, including durability and long-term follow-up;
• Patient selection strategies and shared decision-making tools;
• Emerging pharmacological and interventional therapies;
• Quality of life and global perspectives on AS management.

Dr. Elio Haroun
Dr. Tom Kai Ming Wang
Guest Editors

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• aortic stenosis
• pathophysiology
• multimodality imaging
• echocardiography
• cardiac computed tomography (CT)
• cardiac magnetic resonance (CMR)
• transcatheter aortic valve replacement (TAVR)
• surgical aortic valve replacement (SAVR)
• risk stratification
• prognosis