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Correlation between novel 3D high-resolution manometry esophagogastric junction metrics and pH-metry in reflux disease patients.
Neurogastroenterol Motil. 2018 09; 30(9):e13344.NM

Abstract

BACKGROUND AND AIMS

We recently developed 2 novel 3D high-resolution manometry (HRM) metrics of esophagogastric junction (EGJ) contractility to differentiate the lower esophageal sphincter (LES) and crural diaphragm (CD) elements of EGJ pressure. This study aimed to compare these metrics to the EGJ-contractile integral (EGJ-CI) and to analyze their correlation with esophageal acid exposure time (AET) on pH-metry.

METHODS

Thirty-one gastro-oesophageal reflux disease (GERD) patients and 20 control subjects underwent 24-hour pH-metry and HRM using a 3D-HRM catheter. EGJ metrics were calculated during 3 consecutive respiratory cycles at rest. The EGJ-CI was calculated using the DCI tool in the ManoView software. 3D LES pressure (3D-LESP) and 3D-DHA, a metric quantifying the CD component of the 3D-HRM pressure topography, were calculated using a MATLAB program. Pearson correlation was used to calculate correlations with AET.

KEY RESULTS

3D-LESP, 3D-DHA, and EGJ-CI were all significantly lower in GERD patients than in control subjects (P < .05) and all were significantly correlated with AET (R = -.48, -.42, -.52, respectively, all P < .01). The 3D-DHA and EGJ-CI also strongly correlated with each other (R = .84, P < .001).

CONCLUSIONS & INFERENCES

Both 3D-EGJ metrics were correlated with AET emphasizing the importance of both LES and CD function as a determinant of EGJ competence. 3D-DHA also strongly correlated with the EGJ-CI suggesting that EGJ-CI is strongly driven by the asymmetrical CD pressure component.

Authors+Show Affiliations

Department of Gastroenterology and Hepatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.Department of Gastroenterology and Hepatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.Department of Gastroenterology and Hepatology, First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.Department of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

29644765

Citation

Xiao, Y, et al. "Correlation Between Novel 3D High-resolution Manometry Esophagogastric Junction Metrics and pH-metry in Reflux Disease Patients." Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, vol. 30, no. 9, 2018, pp. e13344.
Xiao Y, Lin Z, Li Y, et al. Correlation between novel 3D high-resolution manometry esophagogastric junction metrics and pH-metry in reflux disease patients. Neurogastroenterol Motil. 2018;30(9):e13344.
Xiao, Y., Lin, Z., Li, Y., Pandolfino, J. E., Chen, M., & Kahrilas, P. J. (2018). Correlation between novel 3D high-resolution manometry esophagogastric junction metrics and pH-metry in reflux disease patients. Neurogastroenterology and Motility : the Official Journal of the European Gastrointestinal Motility Society, 30(9), e13344. https://doi.org/10.1111/nmo.13344
Xiao Y, et al. Correlation Between Novel 3D High-resolution Manometry Esophagogastric Junction Metrics and pH-metry in Reflux Disease Patients. Neurogastroenterol Motil. 2018;30(9):e13344. PubMed PMID: 29644765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Correlation between novel 3D high-resolution manometry esophagogastric junction metrics and pH-metry in reflux disease patients. AU - Xiao,Y, AU - Lin,Z, AU - Li,Y, AU - Pandolfino,J E, AU - Chen,M, AU - Kahrilas,P J, Y1 - 2018/04/11/ PY - 2017/11/08/received PY - 2018/03/05/accepted PY - 2018/4/13/pubmed PY - 2019/11/7/medline PY - 2018/4/13/entrez KW - crural diaphragm KW - diaphragmatic hiatus KW - esophagogastric junction KW - gastro-oesophageal reflux disease KW - high-resolution manometry SP - e13344 EP - e13344 JF - Neurogastroenterology and motility : the official journal of the European Gastrointestinal Motility Society JO - Neurogastroenterol. Motil. VL - 30 IS - 9 N2 - BACKGROUND AND AIMS: We recently developed 2 novel 3D high-resolution manometry (HRM) metrics of esophagogastric junction (EGJ) contractility to differentiate the lower esophageal sphincter (LES) and crural diaphragm (CD) elements of EGJ pressure. This study aimed to compare these metrics to the EGJ-contractile integral (EGJ-CI) and to analyze their correlation with esophageal acid exposure time (AET) on pH-metry. METHODS: Thirty-one gastro-oesophageal reflux disease (GERD) patients and 20 control subjects underwent 24-hour pH-metry and HRM using a 3D-HRM catheter. EGJ metrics were calculated during 3 consecutive respiratory cycles at rest. The EGJ-CI was calculated using the DCI tool in the ManoView software. 3D LES pressure (3D-LESP) and 3D-DHA, a metric quantifying the CD component of the 3D-HRM pressure topography, were calculated using a MATLAB program. Pearson correlation was used to calculate correlations with AET. KEY RESULTS: 3D-LESP, 3D-DHA, and EGJ-CI were all significantly lower in GERD patients than in control subjects (P < .05) and all were significantly correlated with AET (R = -.48, -.42, -.52, respectively, all P < .01). The 3D-DHA and EGJ-CI also strongly correlated with each other (R = .84, P < .001). CONCLUSIONS & INFERENCES: Both 3D-EGJ metrics were correlated with AET emphasizing the importance of both LES and CD function as a determinant of EGJ competence. 3D-DHA also strongly correlated with the EGJ-CI suggesting that EGJ-CI is strongly driven by the asymmetrical CD pressure component. SN - 1365-2982 UR - https://www.unboundmedicine.com/medline/citation/29644765/Correlation_between_novel_3D_high_resolution_manometry_esophagogastric_junction_metrics_and_pH_metry_in_reflux_disease_patients_ L2 - https://doi.org/10.1111/nmo.13344 DB - PRIME DP - Unbound Medicine ER -