title: Assessment of aortic stiffness by transesophageal echocardiography.
abstract: BACKGROUND
  Aortic stiffness, often measured by the carotid/femoral pulse-wave velocity (PWV) method, has become an attractive predictor for cardiovascular (CV) risk. Although noninvasive, PWV requires additional equipment and training. Aortic diameters measured at transesophageal echocardiography (TEE) provide high spatial resolution images as an alternative to PWV, and permit a more routine assessment of aortic stiffness. The purpose of this study was to measure aortic diameters at TEE, calculate aortic stiffness and compare these data to those of the more established PWV as estimates of CV risk and survival.
  
  
  METHODS
  Systolic and diastolic aortic dimensions were measured retrospectively in 500 consecutive patients who had a clinically indicated TEE. Aortic compliance, distensibility, and stiffness index were calculated using the aortic diameters and corrected brachial cuff blood pressures (BP).
  
  
  RESULTS
  Compliance significantly related to age and mean BP (both P < 0.0001) and nearly significantly to chronic renal disease (P = 0.064). The results for distensibility and stiffness index were similar. When analyzed by Kaplan-Meier curves, all stiffness tertiles were significantly predictive of 4.5- to 7.5-year survival. These calculated values behaved similar to those of PWV reported in the literature.
  
  
  CONCLUSIONS
  This study showed that in patients undergoing routine TEE, aortic stiffness can be readily measured and that the derived values offer relationships comparable to those of PWV, including survival prediction. The method may also find use in assessing aortic stiffness in the TEE evaluation of patients with a bicuspid aortic valve or in preparation for transcatheter aortic valve replacement.
authors: Cardiology Division, Department of Medicine, Upstate Medical University, State University of New York, Syracuse, New York.
authors: Orson D
authors: OD
authors: Go
authors: Michel E
authors: ME
authors: Safar
authors: Harold
authors: H
authors: Smulyan
mesh_terms: D000368:Aged; D001011:Aorta / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D017548:Echocardiography, Transesophageal / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D020521:Stroke / Q000000981:diagnostic imaging*; D059289:Vascular Stiffness / Q000502:physiology*
keywords: aorta; transesophageal echocardiography