Pulse Volume Recordings

Rationale

The integration of the 2025 ACC Scientific Statement provides critical clinical context for the use of PVR. While the original text correctly identified that PVR is not affected by calcification, the new evidence emphasizes why this is particularly important in the diabetic population (due to MAC and falsely elevated ABIs). I expanded the abbreviations (PAD, MAC, ABI) as per the instructions and integrated the new citation to reinforce the existing claim while adding specific diagnostic value.

Evidence

Content Changes

* Provides waveform analysis of volume changes.
* Flattened waveforms =indicate severe peripheral arterialartery disease (PAD).
* Advantage: Waveforms are not affected by calcification.medial arterial calcification (MAC), making it a critical diagnostic tool in patients with diabetes where the ankle-brachial index (ABI) may be falsely elevated [@aha2016] [@rutherford2018-rutherford] [@acc2025-h].