| Distal contraction latency: a measure of propagation velocity optimized for esophageal pressure topography studies. | |
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MedLine Citation:
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PMID: 20978487 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: A defining feature of peristalsis is propagation velocity, which determines the timing of the distal contraction relative to the swallow. This study aimed to exploit a coordinate-based strategy to quantify the normal latency of the distal esophageal contraction as a measure of propagation velocity optimized for high-resolution esophageal pressure topography (EPT) studies. METHODS: EPT studies for 75 healthy volunteers were merged in a computer simulation. Swallows were synchronized and analyzed as a 100 × 200 pixel grid that normalized esophageal length from the pharynx to the stomach for a 20-s period to first calculate a composite for each individual and then to establish normative values for the morphology and latency of the distal contraction among individuals. RESULTS: Stereotyped landmarks in composite EPT studies were pressure troughs in the proximal and distal esophagus isolating the distal segment and the contractile deceleration point (CDP) localizing the termination of peristalsis in the distal segment. Distal contractile latency was timed to the CDP (median 6.0 s, 95% confidence interval 4.8-7.6 s) and to lower esophageal sphincter (LES) contraction (median 9.2 s, 95% confidence interval 6.5-11.5 s). Illustrative examples are shown of rapidly conducted contractions with normal or short latency, suggesting short latency to be the preferable EPT metric of rapid propagation. CONCLUSIONS: The proposed scheme, utilizing the topographic coordinates of contraction relative to the swallow as an alternative to conventional measures of peristaltic velocity, lays the foundation for a physiologically grounded classification of peristaltic abnormalities in EPT. Future studies will test the clinical utility of this scheme. |
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Authors:
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Sabine Roman; Zhiyue Lin; John E Pandolfino; Peter J Kahrilas |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural Date: 2010-10-26 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 106 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-03-07 Completed Date: 2011-04-28 Revised Date: 2011-09-13 |
Medline Journal Info:
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Nlm Unique ID: 0421030 Medline TA: Am J Gastroenterol Country: United States |
Other Details:
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Languages: eng Pagination: 443-51 Citation Subset: IM |
Affiliation:
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Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611-2951, USA. roman.sabine@gmail.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Algorithms Deglutition* Esophageal Diseases / physiopathology Esophageal Sphincter, Lower / physiology Esophagus / physiology* Female Humans Male Manometry* Middle Aged Muscle Contraction Peristalsis / physiology* Pressure Reference Values |
| Grant Support | |
ID/Acronym/Agency:
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R01 DK056033-09/DK/NIDDK NIH HHS; R01 DK079902/DK/NIDDK NIH HHS; R01 DK56033/DK/NIDDK NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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