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Esophagogastric junction morphology and contractile integral on high‐resolution manometry in asymptomatic healthy volunteers: An international multicenter study
Author(s) -
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.,
RemesTroche Jose Maria,
Roman Sabine,
Savarino Edoardo,
Serra Jordi,
Sifrim Daniel,
Tolone Salvatore,
Wong Zhiqin,
Zerbib Frank,
Pandolfino John,
Gyawali C. Prakash
Publication year - 2021
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.14009
Subject(s) - high resolution manometry , medicine , esophagogastric junction , asymptomatic , high resolution , nuclear medicine , cardiology , esophagus , adenocarcinoma , cancer , achalasia , remote sensing , geology
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.