title: Aortic distensibility and aortic intima-media thickness in patients without clinical manifestation of atherosclerotic cardiovascular disease.
abstract: BACKGROUND
  There is growing evidence that aortic distensibility (AD) is a subclinical marker of early atherosclerosis. Aortic intima-media thickness (IMT) was an earlier marker than carotid IMT of preclinical atherosclerosis. In this study, we aimed to assess the relationship between thoracic aortic IMT and AD.
  
  
  METHODS
  We studied 192 patients (mean age: 45.5 ± 8.4 years) who underwent transesophageal echocardiography (TEE) for various indications. Four different grades were determined according to IMT of thoracic aorta (Grade 1 < 1 mm; 1 mm ≤ Grade 2 < 3 mm; 3 mm ≤ Grade 3 < 5 mm; 5 mm ≤ Grade 4). AD was calculated from the echocardiographically derived ascending aorta diameters and hemodynamic pressure measurements in all patients. High sensitive C-reactive protein (hsCRP) and other biochemical markers were measured using an automated chemistry analyzer.
  
  
  RESULTS
  TEE evaluation characterized thoracic aortic intimal morphology as grade 1 in 71 patients (37%), grade 2 in 57 patients (29.7%), grade 3 in 34 patients (17.7%), and grade 4 in 30 (15.6%) patients. The lowest AD level was observed in grade 4 group compared with grade 1 and grade 2 groups (P < 0.001, P = 0.009, respectively). AD level of grade 3 group was lower than grade 1 and grade 2 group (P < 0.001, P = 0.021, respectively). In multiple linear regression analysis, AD was independently associated with age (β = -0.138, P = 0.029), hsCRP (β = -0.209, P = 0.001), and aortic IMT (β = -0.432, P < 0.001).
  
  
  CONCLUSIONS
  AD is independently associated with age, thoracic aortic IMT, and hsCRP. Impaired elasticity index of the aorta might be an independent predictor for the severity of thoracic atherosclerosis.
authors.affiliation: Department of Cardiology, Adana Numune Education and Research Hospital, Adana, Turkey.
authors.forename: Zafer
authors.initials: Z
authors.lastname: Elbasan
authors.forename: Durmuş Yıldıray
authors.initials: DY
authors.lastname: Sahin
authors.forename: Mustafa
authors.initials: M
authors.lastname: Gür
authors.forename: Gülhan Yüksel
authors.initials: GY
authors.lastname: Kalkan
authors.forename: Ali
authors.initials: A
authors.lastname: Yıldız
authors.forename: Zekeriya
authors.initials: Z
authors.lastname: Kaya
authors.forename: Ali
authors.initials: A
authors.lastname: Kıvrak
authors.forename: Gökhan
authors.initials: G
authors.lastname: Gözübüyük
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Özdoğru
authors.forename: Murat
authors.initials: M
authors.lastname: Çaylı
mesh_terms: D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging*; D001024:Aortic Valve Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D050197:Atherosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D014421:Turkey / Q000453:epidemiology