Optimizing Assessment of Contraction Reserve in Ineffective Esophageal Motility: A Study of Upright Multiple Rapid Swallows.

IF 3.3 3区医学 Q2 CLINICAL NEUROLOGY

Journal of Neurogastroenterology and Motility Pub Date : 2025-01-31 DOI:10.5056/jnm24097

Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop

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引用次数: 0

Abstract

Background/aims: Multiple rapid swallows (MRS) is a provocative test during high-resolution esophageal manometry (HRM) to evaluate contraction reserve (CR). This study aims to determine the prevalence of CR in patients with ineffective esophageal motility (IEM) and MRS performed in the upright position, and to assess the ideal number of MRS sequences.

Methods: We enrolled adult patients diagnosed with IEM according to the Chicago classification version 4.0 who underwent HRM with 3 MRS sequences. Presence of CR was identified as either: the distal contraction integral (DCI) of the post-MRS sequence exceeding the mean DCI of single swallows (ratio > 1) or the mean DCI of the 3 post-MRS sequences surpassing the mean DCI of single swallows. The occurrence of CR was compared following 1, 2, and 3 MRS sequences.

Results: When assessing CR in 57 patients referenced to mean single supine swallow DCI, the pooled prevalence of CR following 1, 2, and 3 MRS sequences was 23/57 (40.4%), 31/57 (54.4%), and 33/57 (57.9%), respectively. More patients had CR after 2 MRS sequences compared to 1 (P < 0.001), but there was no significant difference in CR between 2 and 3 MRS sequences (P = 0.160). More patients had CR after 2 (P = 0.013) and 3 MRS sequences (P = 0.034) when CR was referenced to single upright compared to single supine swallows.

Conclusion: Among patients with IEM, 58.0% had CR after 3 upright MRS sequences and 2 were adequate to assess CR.

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食管运动无效时收缩储备的优化评估：直立多次快速吞咽的研究。

背景/目的：多次快速吞咽（MRS）是高分辨率食管测压（HRM）中评估收缩储备（CR）的一种刺激试验。本研究旨在确定食管运动不良（IEM）患者在直立位行MRS时CR的发生率，并评估理想的MRS序列数。方法：我们招募了根据芝加哥分类4.0版诊断为IEM的成年患者，他们接受了3个MRS序列的HRM。CR的存在被确定为：mrs后序列的远端收缩积分（DCI）超过单只燕子的平均DCI（比值bbbb1）或3个mrs后序列的平均DCI超过单只燕子的平均DCI。比较1、2、3次MRS序列后CR的发生情况。结果：在评估57例患者的平均单次仰卧吞咽DCI时，1、2和3次MRS序列后CR的总患病率分别为23/57（40.4%）、31/57（54.4%）和33/57（57.9%）。2次MRS后出现CR的患者多于1次（P < 0.001），但2次和3次MRS后CR无显著差异（P = 0.160）。与仰卧吞咽的CR相比，单次直立吞咽的CR在2次（P = 0.013）和3次MRS序列（P = 0.034）后出现CR的患者更多。结论：在IEM患者中，58.0%的患者在3个直立MRS序列后出现CR， 2个序列足以评估CR。

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

Journal of Neurogastroenterology and Motility GASTROENTEROLOGY & HEPATOLOGY-CLINICAL NEUROLOGY

CiteScore

6.30

自引率

8.80%

发文量

期刊介绍： Journal of Neurogastroenterology and Motility (J Neurogastroenterol Motil) is a joint official journal of the Korean Society of Neurogastroenterology and Motility, the Thai Neurogastroenterology and Motility Society, the Japanese Society of Neurogastroenterology and Motility, the Indian Motility and Functional Disease Association, the Chinese Society of Gastrointestinal Motility, the South East Asia Gastro-Neuro Motility Association, the Taiwan Neurogastroenterology and Motility Society and the Asian Neurogastroenterology and Motility Association, launched in January 2010 after the title change from the Korean Journal of Neurogastroenterology and Motility, published from 1994 to 2009.