BACKGROUND: Stiffness of large arteries has been related to cardiovascular mortality, but the mechanisms underlying this relationship have not been established. Variable methods used to estimate this stiffness include carotid ultrasound (CU) and pulse-wave-velocity (PWV). In this study, we searched for a correlation between aortic elastic properties measured by transthoracic echocardiography and well-established surrogates of atherosclerosis. METHODS: The study was conducted on 71 subjects (mean age: 56 짹 12 years; female 47.9%; 28 without and 43 with atherosclerotic risk factors). Patients with coronary artery disease, atrial fibrillation, or left ventricular ejection fraction <50% were excluded. Transthoracic echocardiography was used to measure the aortic stiffness index (AoSI), aortic distensibility (AoD), and aortic strain. High-resolution ultrasound was used to measure carotid intima-media thickness (IMT). Brachial – ankle PWV (baPWV) measures the PWV in the arm and leg by applying air pressure using the volume plethysmographic method. RESULTS: All of the parameters significantly correlated with each other. AoSI, AoD, and aortic strain correlated significantly with age (Spearman���s rho = 0.308, P = 0.009; rho = -0.336, P=0.004: rho=-0.329, P=0.005, respectively), baPWV (rho = 0.347, P = 0.003; rho = -0.373, P=0.001; rho = -0.358, P=0.002, respectively), and carotid IMT (rho=0.317, P=0.007; rho = -0.324, P=0.006; rho=-0.314, P=0.008, respectively). When those values were compared between patients without risk factors and patients with risk factors, only IMT showed significant difference between two groups (7.15 짹 1.67 mm vs. 8.15 짹 1.83 mm, P = 0.02). CONCLUSION: Aortic elastic properties measured by transthoracic echocardiography correlated significantly with well-established noninvasive predictors of atherosclerosis, and we suggest that it can be used as a surrogate for atherosclerosis.