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Esophageal Baseline Impedance From High-resolution Impedance Manometry Correlates With Mean Nocturnal Baseline Impedance From pH-impedance Monitoring

Journal of Neurogastroenterology and Motility 2020년 26권 4호 p.455 ~ 462
Horton Anthony, Sullivan Brian, Charles Katie, McIntosh Thasha, Davis Andrea, Gellad Ziad, Shimpi Rahul, Gyawali C. Prakash, Patel Amit,
소속 상세정보
 ( Horton Anthony ) - Duke University School of Medicine Division of Gastroenterology
 ( Sullivan Brian ) - Duke University School of Medicine Division of Gastroenterology
 ( Charles Katie ) - Duke University School of Medicine Division of Gastroenterology
 ( McIntosh Thasha ) - Durham Veterans Affairs Medical Center
 ( Davis Andrea ) - Durham Veterans Affairs Medical Center
 ( Gellad Ziad ) - Duke University School of Medicine Division of Gastroenterology
 ( Shimpi Rahul ) - Duke University School of Medicine Division of Gastroenterology
 ( Gyawali C. Prakash ) - Washington University School of Medicine Department of Medicine
 ( Patel Amit ) - Duke University School of Medicine Division of Gastroenterology

Abstract


Background/Aims: Esophageal baseline impedance (BI) can be extracted from pH-impedance tracings as mean nocturnal baseline impedance (MNBI), and from high-resolution impedance manometry (HRIM), but it is unknown if values are similar between acquisition methods across HRIM manufacturers. We aim to assess correlations between MNBI and BI from HRIM (BI-HRIM) from 2 HRIM manufacturers in the setting of physiologic acid exposure time (AET).

Methods: HRIM and pH-impedance monitoring demonstrating physiologic AET (< 4%) off proton pump inhibitors were required. BI-HRIM was extracted as the average from 5 cm and 10 cm above the lower esophageal sphincter. Distal BI-HRIM (DBI-HRIM) was also extracted from the most distal channel (Medtronic studies). MNBI was extracted from 6 channels. Concordance between BI-HRIM across manufacturers with MNBI was analyzed.

Results: Thirty-six patients met the inclusion criteria (59.6 ± 1.7 years; 22% female; body mass index 30.5 ± 0.7; AET 1.6 ± 0.2%). Although MNBI was similar at all channels (P ≥ 0.18), Diversatek BI-HRIM was lower than Medtronic BI-HRIM (P = 0.003). Overall, BI-HRIM correlated with MNBI at corresponding recording sites, 7 cm and 9 cm (P < 0.05), but not at other sites (P ≥ 0.19). Pearson’s correlations > 0.5 were seen at MNBI at 7 cm for both systems, and at 9 cm for Medtronic. DBI-HRIM correlated with MNBI at 3 cm and 5 cm (P < 0.03), but not at other locations (P > 0.1).

Conclusions: While numeric differences exist between manufacturers, BI-HRIM correlates with MNBI from corresponding channels in patients with physiologic AET. Comparison with AET elevation is needed to determine correlations between pathologic MNBI with BI-HRIM across manufacturers. The optimal HRIM channels from which BI values should be extracted also warrants further study.

키워드

Electric impedance; Esophageal mucosa; Esophageal pH monitoring; Gastroesophageal reflux

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