DOI: 10.1111/j.1540-8175.2011.01475.x C  2011, Wiley Periodicals, Inc. Impaired Aortic Elastic Properties in Patients with Chronic Graft-versus-Host Disease Orhan Dogdu, M.D., ∗ Mehmet Gungor Kaya, M.D.,† Mikail Yarlioglues, M.D.,† Ali Dogan, M.D.,† Idris Ardic, M.D.,† Deniz Elcik, M.D.,† Nihat Kalay, M.D.,† Leylagul Kaynar, M.D.,‡ Fatih Kurnaz, M.D.,‡ and Namik Kemal Eryol, M.D.† ∗ Department of Cardiology, Yozgat State Hospital Yozgat, Turkey; †Department of Cardiology and ‡Department of Hematology, Erciyes University School of Medicine Kayseri, Turkey Objectives: Graft-versus-host disease (GVHD), which develops as a result of the immunologic response that donor T-lymphocytes generate against host tissue following hematopoietic stem cell transplantation (HSCT), is the leading cause of morbidity and mortality in these patients. The aim of this study is the investigate relation between aortic wall stiffness and duration of the disease in patients with chronic GVHD. Methods: The study population included 32 patients (18 men; mean age, 36.9 ± 12.5 years, and mean disease duration = 14.7 ± 2.9 months) who received HSCT and was diagnosed with GVHD and 44 patients (23 men; mean age, 35.2 ± 9.6 years, and mean disease duration = 13.5 ± 2.4 months) who did not develop GVHD following HSCT. All patients underwent baseline echocardiography before HSCT and were followed. After approximately 10–14 months following HSCT, these patients were divided into two groups based on whether they had developed chronic GVHD, and were compared to aortic stiffness parameters and cardiac functions. Results: There was no change in basal characteristics, laboratory and echocardiographic findings, and aortic stiffness parameters in both groups before HSCT (P > 0.05). After HSCT, the mean aortic strain and distensibility values of the chronic GVHD patients were significantly lower, compared with the non-GVHD patients (9.8 ± 3.2% vs. 12.9 ± 5.0%, P = 0.002 and 4.1 ± 1.5 × 10 −6 cm 2 /dyn vs. 5.3 ± 2.1 × 10 −6 cm 2 /dyn; P = 0.005, respectively). In addition, aortic stiffness index was increased in the chronic GVHD group compared with non-GVHD group (2.7 ± 1.7 vs. 2.0 ± 0.8, P = 0.03). Conclusion: Aortic stiffness measurements were significantly different in chronic GVHD group compared to non-GVHD group and these findings suggested useful explanation for the potential mechanism about the development of disease. (Echocardiography 2011;28:1011-1018) Key words: hematopoietic stem cell transplantation, chronic graft-versus-host disease, aortic stiffness, echocardiography, CRP, atherosclerosis Hematopoietic stem cell transplantation (HSCT) is used for the treatment approach in many hematologic diseases. In patients who re- ceive HSCT, Graft-versus-host disease (GVHD) is the leading cause of morbidity and mortality. GVHD is a result of immunological responses given by the donor’s T-lymphocytes against the host tissues. 1–6 Increased cardiovascular morbid- ity and mortality have been observed in several systemic inflammatory diseases such as systemic lupus erythematosus or rheumatoid arthritis. 7,8 The assessment of aortic stiffness can be cal- culated from pulsatile changes in large artery by using transthoracic echocardiography. 9 Previous studies have shown that noninvasive measure- ments of aortic distensibility, that based on aortic dimensions by echocardiography and blood pres- Conflicts of interest: None. Address for correspondence and reprint requests: Orhan Dogdu, M.D., Yozgat State Hospital, Department of Cardi- ology, 66000 Yozgat, Turkey. Fax: +90 352 4373408; E-mail: orhandogdu@yahoo.com sure data, has same accuracy as invasive meth- ods. 10 The increased arterial stiffness has been recognized as an independent risk factor for car- diovascular disease. 11 Aortic stiffness has been shown to be in association with the inflammatory changes in various diseases, including rheumatoid arthritis, familial Mediterranean fever, Kawasaki’s disease, Marfan’s syndrome, and systemic lupus erythematosus. 12–16 None of these studies investigated arterial stiff- ness relationship in patients with chronic GVHD. Therefore, the aims of this study were to assess- ment aortic stiffness parameters (aortic stiffness index, aortic strain, and distensibility) in patients with chronic GVHD. Method: Study Population: This study was performed between November 2008 and September 2010. Before HSCT, 76 pa- tients were involved in the study. Age, gender, body mass index (BMI), and biochemical mea- surements; fasting blood glucose, high-sensitive 1011