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[The characteristics of esophagogastric junction contractile index in patients with gastroesophageal reflux disease or functional heartburn].
Zhonghua Nei Ke Za Zhi. 2016 Apr 01; 55(4):283-8.ZN

Abstract

OBJECTIVE

To study the role of esophagogastric junction contractile index (EGJ-CI) in evaluating the function of anti-reflux barrier, and in differentiating patients with gastroesophageal reflux disease (GERD) from those with functional heartburn (FH).

METHODS

A total of 115 patients presenting heartburn were enrolled in the study from January 2012 to June 2015.All subjects had completed Gerd-Q questionnaire and undergone gastroscopy, 24-hour pH-impedance monitoring and esophageal high-resolution manometry. GERD patients were divided into as reflux esophagitis, acid-nonerosive reflux disease (NERD) and weakly acid-NERD groups. Patients with normal esophageal mucosa, normal acid exposure and negative proton pump inhibitor test were enrolled in FH group. EGJ-CI (mmHg·cm) as well as EGJ rest pressure and 4s integrated relaxation pressure (IRP 4s) were measured.

RESULTS

Among the 115 patients, 18 were reflux esophagitis [(49.0±18.9) years, M∶F=10∶8], 25 were acid-NERD [(48.7±14.4) years, M∶F=13∶12], 37 were weakly acid-NERD [(52.0±14.8) years, M∶F=15∶22] and 35 were FH [(53.6±14.8), M∶F=8∶27]. No differences of Gerd-Q scores were noticed between the four groups. (1)Negative correlations were demonstrated between EGJ-CI and esophageal acid exposure time (r=-0.283, P=0.002), EGJ-CI and acid reflux events (r=-0.233, P=0.012), EGJ-CI and weakly acid reflux events (r=-0.213, P=0.022), EGJ-CI and non-acid reflux events (r=-0.200, P=0.032). (2)The value of EGJ-CI was significantly higher in FH patients than in the three subgroups of GERD(all P<0.01). EGJ rest pressure of FH group was higher than that of acid-NERD (P<0.01). IRP 4s in acid-NERD group was lower than that of FH and weakly acid-NERD (P<0.05). (3)The area under curve (AUC) of EGJ-CI was higher than that of EGJ-CIT, EGJ rest pressure or IRP 4s(0.686 vs 0.678, 0.641 and 0.578). The cut-off value of EGJ-CI to differentiate GERD from FH was 9.74 mmHg·cm with sensitivity 82.86% and specificity 51.52%.

CONCLUSIONS

The EGJ-CI values are negatively correlated with esophageal acid exposure time, weakly acid reflux events and non-acid reflux events. Thus it might be used as a metric to reflect the anti-reflux function of EGJ. According to the cut-off value of EGJ-CI 9.74 mmHg·cm, patients with GERD can be sensitively differentiated from patients with FH.

Authors+Show Affiliations

Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Evaluation Study
Journal Article

Language

chi

PubMed ID

27030616

Citation

Wang, K, et al. "[The Characteristics of Esophagogastric Junction Contractile Index in Patients With Gastroesophageal Reflux Disease or Functional Heartburn]." Zhonghua Nei Ke Za Zhi, vol. 55, no. 4, 2016, pp. 283-8.
Wang K, Duan LP, Ge Y, et al. [The characteristics of esophagogastric junction contractile index in patients with gastroesophageal reflux disease or functional heartburn]. Zhonghua Nei Ke Za Zhi. 2016;55(4):283-8.
Wang, K., Duan, L. P., Ge, Y., Xia, Z. W., & Xu, Z. J. (2016). [The characteristics of esophagogastric junction contractile index in patients with gastroesophageal reflux disease or functional heartburn]. Zhonghua Nei Ke Za Zhi, 55(4), 283-8. https://doi.org/10.3760/cma.j.issn.0578-1426.2016.04.007
Wang K, et al. [The Characteristics of Esophagogastric Junction Contractile Index in Patients With Gastroesophageal Reflux Disease or Functional Heartburn]. Zhonghua Nei Ke Za Zhi. 2016 Apr 1;55(4):283-8. PubMed PMID: 27030616.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [The characteristics of esophagogastric junction contractile index in patients with gastroesophageal reflux disease or functional heartburn]. AU - Wang,K, AU - Duan,L P, AU - Ge,Y, AU - Xia,Z W, AU - Xu,Z J, PY - 2016/4/1/entrez PY - 2016/4/1/pubmed PY - 2017/1/11/medline SP - 283 EP - 8 JF - Zhonghua nei ke za zhi JO - Zhonghua Nei Ke Za Zhi VL - 55 IS - 4 N2 - OBJECTIVE: To study the role of esophagogastric junction contractile index (EGJ-CI) in evaluating the function of anti-reflux barrier, and in differentiating patients with gastroesophageal reflux disease (GERD) from those with functional heartburn (FH). METHODS: A total of 115 patients presenting heartburn were enrolled in the study from January 2012 to June 2015.All subjects had completed Gerd-Q questionnaire and undergone gastroscopy, 24-hour pH-impedance monitoring and esophageal high-resolution manometry. GERD patients were divided into as reflux esophagitis, acid-nonerosive reflux disease (NERD) and weakly acid-NERD groups. Patients with normal esophageal mucosa, normal acid exposure and negative proton pump inhibitor test were enrolled in FH group. EGJ-CI (mmHg·cm) as well as EGJ rest pressure and 4s integrated relaxation pressure (IRP 4s) were measured. RESULTS: Among the 115 patients, 18 were reflux esophagitis [(49.0±18.9) years, M∶F=10∶8], 25 were acid-NERD [(48.7±14.4) years, M∶F=13∶12], 37 were weakly acid-NERD [(52.0±14.8) years, M∶F=15∶22] and 35 were FH [(53.6±14.8), M∶F=8∶27]. No differences of Gerd-Q scores were noticed between the four groups. (1)Negative correlations were demonstrated between EGJ-CI and esophageal acid exposure time (r=-0.283, P=0.002), EGJ-CI and acid reflux events (r=-0.233, P=0.012), EGJ-CI and weakly acid reflux events (r=-0.213, P=0.022), EGJ-CI and non-acid reflux events (r=-0.200, P=0.032). (2)The value of EGJ-CI was significantly higher in FH patients than in the three subgroups of GERD(all P<0.01). EGJ rest pressure of FH group was higher than that of acid-NERD (P<0.01). IRP 4s in acid-NERD group was lower than that of FH and weakly acid-NERD (P<0.05). (3)The area under curve (AUC) of EGJ-CI was higher than that of EGJ-CIT, EGJ rest pressure or IRP 4s(0.686 vs 0.678, 0.641 and 0.578). The cut-off value of EGJ-CI to differentiate GERD from FH was 9.74 mmHg·cm with sensitivity 82.86% and specificity 51.52%. CONCLUSIONS: The EGJ-CI values are negatively correlated with esophageal acid exposure time, weakly acid reflux events and non-acid reflux events. Thus it might be used as a metric to reflect the anti-reflux function of EGJ. According to the cut-off value of EGJ-CI 9.74 mmHg·cm, patients with GERD can be sensitively differentiated from patients with FH. SN - 0578-1426 UR - https://www.unboundmedicine.com/medline/citation/27030616/[The_characteristics_of_esophagogastric_junction_contractile_index_in_patients_with_gastroesophageal_reflux_disease_or_functional_heartburn]_ L2 - http://journal.yiigle.com/LinkIn.do?linkin_type=pubmed&amp;issn=0578-1426&amp;year=2016&amp;vol=55&amp;issue=4&amp;fpage=283 DB - PRIME DP - Unbound Medicine ER -