Abstract

In chronic hypoxia, structural changes occur in the pulmonary circulation, in particular medial hypertrophy of muscular pulmonary arteries as seen in residents at high altitude,1,2 in alveolar hypoventilation associated with obesity,1,3 and in experimental animal models.4,3 In chronic bronchitis and emphysema, increased muscularization of the peripheral arteries has been described, although its degree and role in the development of cor pulmonale has remained controversial.12 6 In cystic fibrosis, muscle hypertrophy of arteries and of small pulmonary veins, as well as peripheral extension of muscle, has been reported.

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