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Background: Aortic stiffness is associated with many cardiovascular disease as a result of atherosclerosis. We tried to compare the utility of 2D echocardiographic imaging of aorta and pulse wave velocity (PWV) in correlation with aortic stiffness.Methods: A total of 131 patients (male 58.8%, mean age 60.0 ± 15.6) who was performed transesophageal echocardiography (TEE). TEE was performed for evaluation of embolic origin or valvular abnormality and PWV was performed just before TEE. Analysis of M-mode echocardiography was performed in short axis view of descending thoracic aorta.Results: There was significant correlation of change of aortic diameter (%) with age, hypertension history and systolic / diastolic blood pressure. But it was not significantly correlated with PWV (r=-0.07, p=0.067) and it was more significantly correlated with systolic blood pressure at TEE than PWV (r=0.67, p=0.024 vs r=0.31, p=0.02).Conclusion: Aortic distensibility with 2D echocardiography can be more influenced by instantaneous blood pressure than PWV. The echocardiography of thoracic aorta can overestimate the distensibility because of instantaneous high blood pressure.