Pressure-flow characteristics of normal and disordered esophageal motor patterns
Maartje M J Singendonk, Stamatiki Kritas, Charles Cock, Lara F Ferris, Lisa McCall, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, David Moore, Taher I Omari, Maartje M J Singendonk, Stamatiki Kritas, Charles Cock, Lara F Ferris, Lisa McCall, Nathalie Rommel, Michiel P van Wijk, Marc A Benninga, David Moore, Taher I Omari
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.
Copyright © 2015 Elsevier Inc. All rights reserved.
Source: PubMed