Background and Objectives The relationship between left atrial (LA) size and congestive heart failure (CHF) is well recognized; however, there is little information on the association of pulmonary vein (PV) diameter and CHF.The purpose of this study was to investigate the changes of PV and LA sizes in CHF patients by multislice computed tomography (MSCT) angiography using a new 64-slice scanner. Methods and Results We assessed diameters of PVs ostium and LA by 64-slice MSCT with three-dimensional reconstruction in 25 CHF patients and in 26 age- and sex-matched non-CHF controls. Compared with controls, CHF patients showed significant greater diameters of left superior pulmonary vein (LSPV) and right inferior pulmonary vein (RIPV) in both anterior-posterior(AP) and superior-inferior (SI) directions (P<0.01), significant dilation of right superior pulmonary vein (RSPV) in AP direction (P<0.05), as well as significant increase of LA transverse, AP, and SI diameters (P<0.01). Conclusion Significant dilation of PVs with simultaneous LA enlargement was demonstrated in CHF patients. This anatomic and geometric changes may participate in the perpetuation of AF. (J Geriatr Cardiol 2006; 3(1):45-50 ) Background and Objectives The relationship between left atrial (LA) size and congestive heart failure (CHF) is well recognized; however, there is little information on the association of pulmonary vein (PV) diameter and CHF. The purpose of this study was to investigate the changes of PV and LA sizes in CHF patients by multislice computed tomography (MSCT) angiography using a new 64-slice scanner. Methods and Results We rated diameters of PVs ostium and LA by 64-slice MSCT with three-dimensional reconstruction in 25 CHF patients and in 26 age- and sex-matched non-CHF controls. Compared with controls, CHF patients showed significant greater diameters of left superior pulmonary vein (LSPV) and right pulmonary artery (RIPV) in both anterior-posterior (AP) and Significant dilation of the superior superior pulmonary artery (RSPV) in AP direction (P <0.05), as well as significant increase of LA transverse dimension, AP, and SI diameters (P <0.01) Conclusion Sig This anatomic and geometric changes may participate in the perpetuation of AF. (J Geriatr Cardiol 2006; 3 (1): 45-50)