Esophagogastric junction morphology and contractile integral on high‐resolution manometry in asymptomatic healthy volunteers: An international multicenter study. Issue 6 (23rd October 2020)

• Record Type: Journal Article
• Authors: Rogers, Benjamin D.; Rengarajan, Arvind; Abrahao, Luiz; Bhatia, Shobna; Bor, Serhat; Carlson, Dustin A.; Cisternas, Daniel; Gonlachanvit, Sutep; Hani, Albis; Hayat, Jamal; Kawamura, Osamu; Lee, Yeung Yeh; Leguizamo, Ana Maria; Pauwels, Ans; Perez de la Serna, Julio; Ramos, Rosa I.; Remes‐Troche, Jose Maria; Roman, Sabine; Savarino, Edoardo; Serra, Jordi; Sifrim, Daniel; Tolone, Salvatore; Wong, Zhiqin; Zerbib, Frank; Pandolfino, John; Gyawali, C. Prakash
• Is Part Of: Neurogastroenterology & motility. Volume 33:Issue 6(2021)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-10-23
• Subjects: barrier function -- esophagogastric junction -- lower esophageal sphincter pressure; Gastrointestinal system -- Motility -- Periodicals; Gastrointestinal system -- Innervation -- Periodicals; 616.33
• DOI: 10.1111/nmo.14009
• Languages: English
• ISSNs: 1350-1925

Abstract

Abstract: Background: Esophagogastric junction contractile integral (EGJ‐CI) and EGJ morphology are high‐resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited. Methods: Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ‐CI was calculated by the same two investigators using a distal contractile integral‐like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg cm), using manufacturer‐specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ‐CI values were calculated across age, genders, HRM systems, and regions. Results: Of 484 studies (28.0 years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ‐CI was similar between Medtronic (37.0 mm Hg cm, IQR 23.6‐53.7 mm Hg cm) and Diversatek (34.9 mm Hg cm, IQR 22.1‐56.1 mm Hg cm, P = 0.87), but was significantly higher using Laborie equipment (56.5 mm Hg cm, IQR 35.0‐75.3 mm Hg cm, P < 0.001). 5 th percentile EGJ‐CI values ranged from 6.9 to 12.1 mm Hg cm. EGJ‐CI values were consistent across world regions, but different between manufacturers even within the same world region ( P ≤ 0.001). Within Medtronic studies, EGJ‐CI and basal LESP were similar in younger and older individuals ( P ≥ 0.3) but higher in women ( P < 0.001). Conclusions: EGJ morphology is predominantly type 1 in healthy adults. EGJ‐CI varies widely in health, with significant gender influence, but is consistent within each HRM system. Manufacturer‐specific normative values should be utilized for clinical HRM interpretation. Abstract : Esophagogastric junction (EGJ) morphology is predominantly type 1 in healthy adults; EGJ‐contractile integral (EGJ‐CI) varies widely in health, with significant gender influence, but is consistent within each HRM system.