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To investigate whether microvascular lesions are present in the skin of patients with chronic congestive heart failure (CHF), skin biopsies were performed at the time of cardiac catheterization, and the results were compared with control subjects. The diagnosis of CHF was done by cardiac catheterization with reference to the elevation of plasma levels of brain natriuretic peptide (BNP). Although the severity of arteriolar hyalinosis did not correlate with the New York Heart Association functional class, increased hyalinosis was found in skin biopsies from 17 of 20 patients with CHF, but in none of the 6 control subjects. These results indicate that microangiopathic alterations in arterioles may exist in patients with CHF and therapy for peripheral vascular remodeling might be considered for such patients.

Evaluation of Arteriolar Hyalinosis of the Skin of Patients With Chronic Congestive Heart Failure.