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Figure 3 A representative coronary angiogram and simultaneous tracing of aortic and intracoronary trans-stenotic pressure signals in a 62-year-old man. The patient had angiographically intermediate stenosis (68% diameter stenosis) of the mid left anterior descending coronary artery (A and B; right anterior oblique and left anterior oblique coronary arteries projections, respectively). The pressure recordings in C were simultaneously obtained by the guiding catheter (fluid-filled) (solid line) and the pressure wire (dotted line), while the sensor of the pressure wire was located both proximal and distal to the lesion. Distal pressure recording was obtained both at baseline and during adenosine-induced hyperemia (C). When reached to maximal hyperemic state by administrating incremental dosages of adenosine, the calculated fractional flow reserve (FFR) was found to be 0.57. The distal pressure waveform in D (lower waveform) was significantly altered as compared with the baseline proximal signal (upper waveform). This is especially prominent with regard to the absence of the dicrotic notch in the distal waveform, indicating attenuation of the high-frequency components of the pressure waveform across the stenosis and resulting in a pulse transmission coefficient value of 0.32, which suggest, in accordance with the FFR value, a functionally significant lesion.Continued on next page.
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