Impaired aortic elastic properties in patients with chronic graft-versus-host disease

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.

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.

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) cm2/dyn vs. 5.3±2.1×10(-6) cm2/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).

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.