A 52-year-old man with a 15-year history of COPD presents with progressive dyspnea and lower limb edema. His ECG shows the findings labeled in the diagram. The structure marked **B** (Tall R Wave in V1 with R > S) is a key ECG finding in right ventricular hypertrophy. Which of the following is the MOST LIKELY underlying pathophysiology responsible for this ECG change?