Comparative Prevalence of Ineffective Esophageal Motility: Impact of Chicago v4.0 vs. v3.0 Criteria

Q4 Medicine

Medicina Pub Date : 2024-09-08 DOI:10.3390/medicina60091469

Teodora Surdea-Blaga, Stefan-Lucian Popa, Cristina Maria Sabo, Radu Alexandru Fărcaş, Liliana David, Abdulrahman Ismaiel, Dan Lucian Dumitrascu, Simona Grad, Daniel Corneliu Leucuta

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引用次数: 0

Abstract

Background and Objectives: The threshold for ineffective esophageal motility (IEM) diagnosis was changed in Chicago v4.0. Our aim was to determine IEM prevalence using the new criteria and the differences between patients with definite IEM versus “inconclusive diagnosis”. Materials and Methods: We retrospectively selected IEM and fragmented peristalsis (FP) patients from the high-resolution esophageal manometries (HREMs) database. Clinical, demographic data and manometric parameters were recorded. Results: Of 348 HREMs analyzed using Chicago v3.0, 12.3% of patients had IEM and 0.86% had FP. Using Chicago v4.0, 8.9% of patients had IEM (IEM-4 group). We compared them with the remaining 16 with an inconclusive diagnosis of IEM (borderline group). Dysphagia (77% vs. 44%, Z-test = 2.3, p = 0.02) and weight loss were more commonly observed in IEM-4 compared to the borderline group. The reflux symptoms were more prevalent in the borderline group (87.5% vs. 70.9%, p = 0.2). Type 2 or 3 esophagogastric junction morphology was more prevalent in the borderline group (81.2%) vs. 64.5% in IEM-4 (p = 0.23). Distal contractile integral (DCI) was lower in IEM-4 vs. the borderline group, and resting lower esophageal sphincter (LES) pressure and mean integrated relaxation pressure (IRP) were similar. The number of ineffective swallows and failed swallows was higher in IEM-4 compared to the borderline group. Conclusions: Using Chicago v4.0, less than 10% of patients had a definite diagnosis of IEM. The dominant symptom was dysphagia. Only DCI and the number of failed and inefficient swallows were different between definite IEM patients and borderline cases.

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食管运动功能障碍的患病率比较：芝加哥 v4.0 标准与 v3.0 标准的影响

背景和目的：食管运动功能障碍（IEM）诊断的阈值在芝加哥版本 4.0 中有所改变。我们的目的是根据新标准确定 IEM 的患病率，以及明确诊断为 IEM 的患者与 "诊断不明确 "的患者之间的差异。材料和方法：我们从高分辨率食管压力计（HREMs）数据库中回顾性地选择了 IEM 和肠蠕动减弱（FP）患者。记录了临床、人口统计学数据和测压参数。结果：在使用芝加哥 v3.0 分析的 348 个 HREM 中，12.3% 的患者有 IEM，0.86% 的患者有 FP。使用芝加哥 v4.0 分析，8.9% 的患者有 IEM（IEM-4 组）。我们将他们与其余 16 名未确诊为 IEM 的患者（边缘组）进行了比较。与边缘组相比，吞咽困难（77% 对 44%，Z 检验 = 2.3，P = 0.02）和体重减轻在 IEM-4 组中更为常见。反流症状在边缘组更为普遍（87.5% 对 70.9%，P = 0.2）。2型或3型食管胃交界处形态在边缘组更常见（81.2%），而在IEM-4组为64.5%（P = 0.23）。IEM-4组的远端收缩积分（DCI）低于边缘组，静息食管下括约肌（LES）压力和平均综合松弛压力（IRP）相似。与边缘组相比，IEM-4 组的无效吞咽和失败吞咽次数较多。结论：使用 Chicago v4.0，只有不到 10% 的患者被明确诊断为 IEM。主要症状是吞咽困难。只有 DCI 以及吞咽失败和吞咽效率低下的次数在确诊的 IEM 患者和边缘病例之间存在差异。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Medicina Medicine-Medicine (all)

CiteScore

0.10

自引率

0.00%

发文量

审稿时长

24 weeks

期刊介绍： Publicada con el apoyo del Ministerio de Ciencia, Tecnología e Innovación Productiva. Medicina no tiene propósitos comerciales. El objeto de su creación ha sido propender al adelanto de la medicina argentina. Los beneficios que pudieran obtenerse serán aplicados exclusivamente a ese fin.