Abstract

Patients with chronic congestive heart failure (CHF) frequently develop secondary pulmonary hypertension. This development is a poor prognostic indicator. 1 In addition, secondary pulmonary hypertension that does not improve in response to vasodilators identifies a group of patients who will have a poor outcome after orthotopic heart transplantation. 2,3 The structural abnormalities of the pulmonary artery that occur in CHF have been described in autopsy specimens, 4 and human studies have demonstrated indirectly that there are alterations in pulmonary vascular impedance and stiffness. 5,6 Intravascular ultrasound using high-frequency catheter-based imaging has been performed to quantify pulmonary artery area and diameter in humans. 7 It also has been validated as a method of detecting plaque in both elastic and muscular arteries. 8 We hypothesized that intravascular ultrasound could be used to characterize the changes in pulmonary vascular morphology and elasticity in CHF.

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