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The association between systemic sclerosis disease manifestations and esophageal high‐resolution manometry parameters
Author(s) -
Kimmel J. N.,
Carlson D. A.,
Hinchcliff M.,
Carns M. A.,
Aren K. A.,
Lee J.,
Pandolfino J. E.
Publication year - 2016
Publication title -
neurogastroenterology and motility
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.489
H-Index - 105
eISSN - 1365-2982
pISSN - 1350-1925
DOI - 10.1111/nmo.12813
Subject(s) - dlco , medicine , high resolution manometry , esophageal motility disorder , pulmonary function testing , dysphagia , contractility , gastroenterology , esophageal dilatation , cardiology , disease , esophagus , surgery , reflux , lung , lung function , diffusing capacity
Background We aimed to evaluate the associations between systemic sclerosis ( SS c)‐related systemic manifestations and esophageal function using high‐resolution manometry ( HRM ). Methods Patients with SS c that had undergone HRM between 1/2004 and 9/2014 were identified and HRM s were analyzed according to the Chicago Classification. Clinical characteristics were identified via retrospective chart review and compared among motility diagnoses while adjusting for age, gender, race, and SS c‐disease duration. Key Results Seventy‐nine patients (85% female, ages 25–77) were included. Clinical characteristics were compared between patients with absent contractility ( AC , n = 40), ineffective esophageal motility ( IEM ; n = 15), and normal motility ( n = 19); the five remaining patients met criteria for other motility diagnoses. Groups differed in severity of skin involvement measured by the modified Rodnan skin score (0–51): AC (adjusted mean 12.6), IEM (4.4), normal (4.3), p = 0.043. Pulmonary function tests [percent predicted FVC and DLCO ) were lower in AC (adjusted mean, FVC : 70.3, DLCO 51.1), than IEM ( FVC : 92.0; DLCO : 76.9) and normal motility ( FVC : 80.0; DLCO : 67.2), p values 0.057 ( FVC ) and 0.007 ( DLCO ). Groups did not differ by SS c‐disease duration, autoantibodies, or reported symptoms of dysphagia or reflux. Conclusions & Inferences In patients with SS c, absent esophageal contractility on HRM was associated with increased skin disease severity and worse lung function. Obtaining HRM to identify SS c patients with more severe esophageal dysfunction could be considered to enable implementation of management strategies in patients potentially at risk for increased morbidity and mortality.