Pressure-flow characteristics of normal and disordered esophageal motor patterns

Maartje Singendonk, Stamatiki Kritas, Charles Cock, Lara Ferris, Lisa McCall, Nathalie Rommel, Michiel van Wijk, Marc Benninga, D Moore, Taher Omari

    Research output: Contribution to journalArticlepeer-review

    17 Citations (Scopus)

    Abstract

    Objective To perform pressure-flow analysis (PFA) in a cohort of pediatric patients who were referred for diagnostic manometric investigation. Study design PFA was performed using purpose designed Matlab-based software. The pressure-flow index (PFI), a composite measure of bolus pressurization relative to flow and the impedance ratio, a measure of the extent of bolus clearance failure were calculated. Results Tracings of 76 pediatric patients (32 males; 9.1 ± 0.7 years) and 25 healthy adult controls (7 males; 36.1 ± 2.2 years) were analyzed. Patients mostly had normal motility (50%) or a category 4 disorder and usually weak peristalsis (31.5%) according to the Chicago Classification. PFA of healthy controls defined reference ranges for PFI <142 and impedance ratio 0.49. Pediatric patients with pressure-flow (PF) characteristics within these limits had normal motility (62%), most patients with PF characteristics outside these limits also had an abnormal Chicago Classification (61%). Patients with high PFI and disordered motor patterns all had esophagogastric junction outflow obstruction. Conclusions Disordered PF characteristics are associated with disordered esophageal motor patterns. By defining the degree of over-pressurization and/or extent of clearance failure, PFA may be a useful adjunct to esophageal pressure topography-based classification.

    Original languageEnglish
    Pages (from-to)690-696.e1
    Number of pages7
    JournalJournal of Pediatrics
    Volume166
    Issue number3
    DOIs
    Publication statusPublished - 1 Mar 2015

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