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. Author manuscript; available in PMC: 2022 Sep 14.
Published in final edited form as: J Am Coll Cardiol. 2021 Sep 14;78(11):1145–1165. doi: 10.1016/j.jacc.2021.06.049

Figure 3. MAC and hemodynamics.

Figure 3.

Male with diabetes mellitus and gangrene of the right middle finger and X-ray angiography demonstrating advanced MAC without evidence of stenotic lesions of the right upper extremity arteries. (A) High fidelity blood pressure recordings at the level of the mid brachial (Pa) and distal ulnar (Pd) arteries demonstrated Pd/Pa-ratio of 0.91 at baseline, (B) Pd/Pa-ratio of 0.80 following intravenous (140 μg/kg/min systemic infusion) and intra-arterial (150 μg) bolus administration of adenosine and (C) Pd/Pa-ratio of 0.76 following intra-arterial nitroglycerin (300 μg). The disproportional decrease in the distal diastolic pressures following vasodilatation appears to suggest marked microvascular dysfunction. Hemodynamically significant lesion proximal to the target territory has been excluded by X-ray angiography.