Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop
{"title":"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。","authors":"Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop","doi":"10.5056/jnm24097","DOIUrl":null,"url":null,"abstract":"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 0.001), but there was no significant difference in CR between 2 and 3 MRS sequences (<i>P</i> = 0.160). More patients had CR after 2 (<i>P</i> = 0.013) and 3 MRS sequences (<i>P</i> = 0.034) when CR was referenced to single upright compared to single supine swallows.</p><p><strong>Conclusion: </strong>Among patients with IEM, 58.0% had CR after 3 upright MRS sequences and 2 were adequate to assess CR.</p>","PeriodicalId":16543,"journal":{"name":"Journal of Neurogastroenterology and Motility","volume":"31 1","pages":"38-44"},"PeriodicalIF":3.3000,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735207/pdf/","citationCount":"0","resultStr":"{\"title\":\"Optimizing Assessment of Contraction Reserve in Ineffective Esophageal Motility: A Study of Upright Multiple Rapid Swallows.\",\"authors\":\"Tian Li, D Chamil Codipilly, Diana Snyder, Karthik Ravi, Maoyin Pang, Andree H Koop\",\"doi\":\"10.5056/jnm24097\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background/aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (<i>P</i> < 0.001), but there was no significant difference in CR between 2 and 3 MRS sequences (<i>P</i> = 0.160). More patients had CR after 2 (<i>P</i> = 0.013) and 3 MRS sequences (<i>P</i> = 0.034) when CR was referenced to single upright compared to single supine swallows.</p><p><strong>Conclusion: </strong>Among patients with IEM, 58.0% had CR after 3 upright MRS sequences and 2 were adequate to assess CR.</p>\",\"PeriodicalId\":16543,\"journal\":{\"name\":\"Journal of Neurogastroenterology and Motility\",\"volume\":\"31 1\",\"pages\":\"38-44\"},\"PeriodicalIF\":3.3000,\"publicationDate\":\"2025-01-31\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11735207/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Neurogastroenterology and Motility\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.5056/jnm24097\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurogastroenterology and Motility","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.5056/jnm24097","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
Optimizing Assessment of Contraction Reserve in Ineffective Esophageal Motility: A Study of Upright Multiple Rapid Swallows.
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.
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.
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