{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:58:24Z","timestamp":1790697504385,"version":"4.1.0"},"reference-count":113,"publisher":"IMR Press","issue":"9","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. Cardiovasc. Med."],"abstract":"<jats:p>Transcatheter aortic valve implantation (TAVI) elicits a sterile inflammatory response that is almost universal, yet highly heterogeneous in both magnitude and clinical impact. Initiated by endothelial injury, ischemia\u2013reperfusion, and residual bioprosthetic immunogenicity, peri-procedural inflammation converges on activation of the NOD-like receptor family pyrin domain-containing 3 (NLRP3) inflammasome and downstream interleukin-1\u03b2 (IL-1\u03b2) and IL-6 signaling, leading to increased C-reactive protein levels. This response is further modulated by patient susceptibility, procedural complexity, and device-specific characteristics. While a controlled response promotes tissue repair and healing, exaggerated activation, which manifests as systemic inflammatory response syndrome in up to two-thirds of patients, has been consistently associated with higher mortality, conduction disturbances, new-onset atrial fibrillation, acute kidney injury (AKI), and subclinical leaflet thrombosis. Emerging evidence also implicates gut microbiome-derived metabolites and xenoantigen-driven adaptive immunity as additional contributors to the overall inflammatory burden. Serial biomarker assessment, including C-reactive protein trajectories, neutrophil-to-lymphocyte ratio, cancer antigen 125 (CA-125), and novel composite indices such as the neutrophil percentage-to-albumin ratio, combined with multimodality imaging, allows increasingly refined risk stratification. However, no anti-inflammatory therapy is currently established for routine use after TAVI. Colchicine has shown proof-of-concept signals, sodium\u2013glucose cotransporter 2 inhibitors have demonstrated clinical benefit with pleiotropic anti-inflammatory properties, and lessons from IL-1 and IL-6 inhibition trials in ischemic heart disease provide a translational roadmap. This narrative review synthesizes the epidemiology, mechanisms, clinical consequences, and assessment of peri-TAVI inflammation. Moreover, this review proposes a pragmatic inflammatory subphenotyping framework that integrates baseline risk, procedural exposure, and biomarker kinetics. Such a framework may help bridge the gap between observational associations and precision-based therapeutic strategies, shifting peri-TAVI inflammation from a prognostic marker to a modifiable determinant of outcome.<\/jats:p>","DOI":"10.31083\/rcm52850","type":"journal-article","created":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:57:11Z","timestamp":1790693831000},"source":"Crossref","is-referenced-by-count":0,"title":["Inflammation After Transcatheter Aortic Valve Implantation: Mechanisms, Risk Stratification, and Therapeutic Implications"],"prefix":"10.31083","volume":"27","author":[{"given":"Mihail","family":"Celeski","sequence":"first","affiliation":[{"name":"Department of Cardiology, Fabrizio Spaziani Hospital, 03100 Frosinone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-1835-6128","authenticated-orcid":true,"given":"Michele","family":"Marchetta","sequence":"additional","affiliation":[{"name":"Berne Cardiovascular Research Center and Division of Cardiology, University of Virginia, Charlottesville, VA 22903, USA"},{"name":"Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2873-9654","authenticated-orcid":true,"given":"Emanuele","family":"Sammartini","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Policlinico Casilino, 00169 Rome, Italy"},{"name":"Department of Experimental and Clinical Medicine, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Sorropago","sequence":"additional","affiliation":[{"name":"Department of Interventional Cardiology, Policlinico di Monza, 20900 Monza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattia","family":"Basile","sequence":"additional","affiliation":[{"name":"Cardiology Department, La Paz University Hospital, 28046 Madrid, Spain"},{"name":"Fundaci\u00f3n de Investigaci\u00f3n IDIPAZ, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Morello","sequence":"additional","affiliation":[{"name":"Berne Cardiovascular Research Center and Division of Cardiology, University of Virginia, Charlottesville, VA 22903, USA"},{"name":"Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmine","family":"Salzillo","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular and Pulmonary Sciences, Universit\u00e0 Cattolica del Sacro Cuore, 00168 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Bernardi","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Santa Maria Goretti, 04100 Latina, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pasquale","family":"Mollo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Fabrizio Spaziani Hospital, 03100 Frosinone, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisco Jos\u00e9","family":"Romeo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Miami Miller School of Medicine, Jackson Memorial Hospital, Miami, FL 33136, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arturo","family":"Cesaro","sequence":"additional","affiliation":[{"name":"Department of Translational Medical Sciences, University of Campania Luigi Vanvitelli, 80138 Naples, Italy"},{"name":"Division of Cardiology, A.O.R.N. \u201cSant'Anna e San Sebastiano\u201d, 81100 Caserta, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Golino","sequence":"additional","affiliation":[{"name":"Berne Cardiovascular Research Center and Division of Cardiology, University of Virginia, Charlottesville, VA 22903, USA"},{"name":"Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University, Richmond, VA 23284, USA"},{"name":"Division of Cardiology, University of Florida College of Medicine, Jacksonville, FL 32209, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"16242","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Praz F, Borger MA, Lanz J, Marin-Cuartas M, Abreu A, Adamo M, et al. 2025 ESC\/EACTS Guidelines for the management of valvular heart disease. 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