Document Detail


Adding a radial dimension to the assessment of esophagogastric junction relaxation: validation studies of the 3D-eSleeve.
MedLine Citation:
PMID:  22628033     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
High-resolution manometry (HRM) with esophageal pressure topography (EPT) allowed for the establishment of an objective quantitative measurement of esophagogastric junction (EGJ) relaxation, the integrated relaxation pressure (IRP). This study assessed whether or not a novel 3D-HRM assembly could improve on this measurement. Twenty-five normal subjects were studied with both a standard HRM assembly and a novel hybrid assembly (3D-HRM), including a 9.0 cm 3D-HRM segment composed of 96 radially dispersed independent pressure sensors. The standard IRP was computed using each assembly and compared with a novel paradigm, the 3D-IRP, an analysis premised on finding the axial maximum and radial minimum pressure at each sensor ring along the sleeve segment. Fourteen additional subjects underwent barium swallows with 3D-HRM and concurrent videofluoroscopy to compare the electronic sleeve (eSleeve) paradigm (circumferential average) to the 3D eSleeve paradigm (radial minimum) as a predictor of transphincteric flow. The 3D-IRP was significantly less than all other calculations of IRP with the upper limit of normal being 12 mmHg vs. 17 mmHg for the standard IRP. The sensitivity (0.78) and the specificity (0.88) of the 3D-eSleeve were also better than the standard eSleeve (0.55 and 0.85, respectively) for predicting flow permissive time verified fluoroscopically. The 3D-IRP and 3D-eSleeve calculated using the radial pressure minimum lowered the normative range of EGJ relaxation (upper limit of normal 12 mmHg) and yielded intraluminal pressure gradients that better correlated with bolus flow than did analysis paradigms based on circumferentially averaged pressure.
Authors:
Frédéric Nicodème; John E Pandolfino; Zhiyue Lin; Yinglian Xiao; Gabriela Escobar; Peter J Kahrilas
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural     Date:  2012-05-24
Journal Detail:
Title:  American journal of physiology. Gastrointestinal and liver physiology     Volume:  303     ISSN:  1522-1547     ISO Abbreviation:  Am. J. Physiol. Gastrointest. Liver Physiol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-02     Completed Date:  2012-10-11     Revised Date:  2013-08-14    
Medline Journal Info:
Nlm Unique ID:  100901227     Medline TA:  Am J Physiol Gastrointest Liver Physiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  G275-80     Citation Subset:  IM    
Affiliation:
Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA. fnicodeme@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Deglutition
Esophageal Sphincter, Lower
Esophagogastric Junction / physiology*
Female
Fluoroscopy / methods
Humans
Male
Manometry / instrumentation,  methods
Middle Aged
Muscle Relaxation / physiology*
Pressure
Sensitivity and Specificity
Grant Support
ID/Acronym/Agency:
R01-DK-079902/DK/NIDDK NIH HHS; R01-DK-56033/DK/NIDDK NIH HHS
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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