Arterial stiffening may contribute to secondary myocardial dysfunction. The aim of this study was to assess the stiffness of the thoracic descending aorta (TDA) by performing strain-rate measurements with transesophageal echocardiography (TEE) and to examine the relation of the findings to left ventricular (LV) function. Eight patients (group I) without risk factors for arteriosclerosis and 52 patients (group II) with a high risk of arteriosclerosis underwent transthoracic echocardiography (TTE) and TEE simultaneously. The values of distensibility of the TDA (-SR) in groups I and II were -11.7 +/- 2.4 and -4.6 +/- 2.5, respectively (p<0.001), and the values of the recoil of the TDA (+SR) were 20.5 +/- 8.2 and 6.8 +/- 5.0, respectively (p<0.001). The LV ejection fraction showed no relation with -SR or +SR, but LV diastolic function (e' and E/e') was correlated with +SR (p=0.002 and p=0.046, respectively). Strain-rate measurements obtained with TEE were useful for evaluating impairment of the elastic properties of the TDA and the pathophysiologic mechanisms underlying the arterial-ventricular relationship.