| Utilizing intraluminal pressure gradients to predict esophageal clearance: a validation study. | |
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MedLine Citation:
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PMID: 18637086 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Esophageal bolus clearance requires a preferential esophagogastric pressure gradient sustained for a sufficient period. We aimed to validate a high-resolution manometry (HRM) paradigm for predicting bolus clearance. METHODS: Twenty volunteers and 30 patients were studied with HRM during barium swallows with concurrent fluoroscopy. Simultaneous bolus domain pressure and esophagogastric junction (EGJ) obstruction pressure were plotted and flow permissive time was tallied during which the bolus domain pressure exceeded the EGJ obstruction pressure. Distal peristaltic integrity was assessed at incrementally increasing pressure isobaric contour thresholds from 15-40 mmHg. ROC analysis was performed to assess the sensitivity and specificity of cutoff values for flow permissive time and peristaltic amplitude for predicting incomplete clearance as verified fluoroscopically. RESULTS: Flow permissive time < or =2.5 s had a sensitivity of 86% and specificity of 92% for predicting incomplete clearance. In contrast, a 30-mmHg peristaltic amplitude had a sensitivity of only 48% and specificity of 88%. Incomplete clearance was variably attributable to functional EGJ obstruction, hiatus hernia, or impaired peristalsis. CONCLUSIONS: A detailed analysis of intraluminal pressure gradients in the distal esophagus and across the EGJ in the postdeglutitive period predicts esophageal bolus clearance with far greater accuracy than any threshold value of peristaltic amplitude. |
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Authors:
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John E Pandolfino; Sudip K Ghosh; Nilesh Lodhia; Peter J Kahrilas |
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Publication Detail:
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Type: Controlled Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies Date: 2008-07-12 |
Journal Detail:
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Title: The American journal of gastroenterology Volume: 103 ISSN: 1572-0241 ISO Abbreviation: Am. J. Gastroenterol. Publication Date: 2008 Aug |
Date Detail:
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Created Date: 2008-09-17 Completed Date: 2008-10-21 Revised Date: 2010-12-03 |
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: 1898-905 Citation Subset: IM |
Affiliation:
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Departments of Medicine, The Feinberg School of Medicine, Northwestern University, Chicago, Illinois 60611, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Catheterization Deglutition / physiology Esophageal Motility Disorders / physiopathology*, radiography Esophagogastric Junction / physiopathology*, radiography Female Fluoroscopy Gastrointestinal Motility / physiology* Humans Male Manometry / methods* Middle Aged Predictive Value of Tests Reproducibility of Results Transducers, Pressure |
| Grant Support | |
ID/Acronym/Agency:
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R01 DC000646-09/DC/NIDCD NIH HHS; R01 DC00646/DC/NIDCD NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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