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Purpose: Elastic properties of the aorta in b-thalassemia(B-T) major patients, plays role in development of cardiac dysfunction by affecting afterload. Few studies exist about that issue. We assessed the aorta distensibility, aortic stiffness and pulse wave velocity using echo applications in pts with B-T.Methods: We studied 28 pts (33.53±8.39 years) and 18 age matched controls (31.5±8.19 years) Exclusion criteria were age >45, rhythm other than sinus, smoking, mean hemoglobin < 8.5 g/dl, systolic left ventricle dysfunction, systemic and pulmonary hypertension, diabetes mellitus and thyroid disease. Blood pressure was measured. Aortic systolic (AoS), diastolic (AoD) diameters were calculated by M-Mode. Aortic distensibility and stiffness index were calculated by 2x(AoS-AoD)/(SAP-DAP)xAoD and ln(SAP/DAP)/( AoS-AoD)/AoD. PW-D (PWD) tracings of ascending and descending aortas recorded. From R of QRS to onset of PWD aortic flow, time 1 (T1) in ascending aorta and time 2 (T2) in descending aorta were measured accordingly. Aortic length (AOL) was measured from Two-D and defined as distance from PWD sample volume in descending aorta to ascending aorta adjacent to right pulmonary artery. The following calculations were used: transit time (TT)=t2-t1 and PWVr=AOL/TT (m/s). Standard M-mode, PWD and TDI mean septal-lateral mitral annulus velocities measurements were also obtained (EF, LVEDD, LVESD, IVS and PW thickness, Left atrial diameter, Emax, Amax, DT, IVRT, IVCT,PASP and Sm, Em, Am).Results: Differences between classic echo indices were observed between pts and controls for EF(64.53±7.4 vs 69±2.2 respectively, p=0.46), Left atrial diameter (37.5±4 vs 34.6±2.5 respectively, p=0.004), PASP (25±7.7 vs 13±7.1 respectively, p=0.000),Emax (99.6±15.3 vs 88.7±15.2 respectively, p=0.028) and Em (11.7±3.8 vs 14.2±3.2 respectively, p=0.032). Indices of aorta properties in table.Conclusions: PTs with B-T, except from differences in classic echo indices which are known from previous studies, have altered elastic properties of the aorta like distensibility maybe as a result of iron load of the aorta wall.