Clinical impact of different cut-off values in high-resolution manometry systems on diagnosing esophageal motility disorders

Kuribayashi, Shiko; Iwakiri, Katsuhiko; Shinozaki, Tomohiro; Hosaka, Hiroko; Kawada, Akira; Kawami, Noriyuki; Hoshino, Shintaro; Takenouchi, Nana; Sugiyama, Yasuyuki; Kawamura, Osamu; Kusano, Motoyasu; Uraoka, Toshio

doi:10.1007/s00535-019-01608-3

Cited by 29 publications

(23 citation statements)

References 8 publications

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“…Second, only the Unisensor catheter (Starlet) was used in this study. Unisensor and Manoscan TM (Medtronic, Minneapolis, MN, USA) catheters are available in the HRM system, and each catheter has different cutoff values for the Chicago classifications [17, 19]. In our study, however, a comparison of the parameters for both catheter types resulted in no difference in esophageal manometry diagnoses.…”

Section: Discussion/conclusionmentioning

confidence: 62%

“…Other esophageal manometry diagnoses were also evaluated, with the following cut-off values: Contractile vigor was assessed using the DCI (a contraction with a DCI <500 mm Hg-s-cm was failed, a DCI >500 but <1,000 mm Hg-s-cm was weak, and a hypercontractile swallow was defined as a DCI ≥10,000 mm Hg-s-cm). A premature contraction was defined as the presence of a DL <4.5 s [19].…”

Section: Methodsmentioning

confidence: 99%

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Comparison of High-Resolution Manometry in Patients Complaining of Dysphagia among Patients with or without Diabetes Mellitus

et al. 2020

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Introduction: Dysphagia is a common symptom that occurs in patients with diabetes mellitus (DM). There have been few prospective observational studies on esophageal motility disorders in DM using high-resolution manometry (HRM). This study aimed to clarify the characteristics of esophageal motility disorders using HRM in patients with dysphagia and compare them between DM and non-DM patients. Methods: Patients with dysphagia were prospectively recruited between October 2018 and July 2019. Patients (n = 89) underwent esophagogastroduodenoscopy and HRM and completed the Gastrointestinal Symptom Rating Scale (GSRS) questionnaire. Manometry parameters and motility disorder classifications were compared between DM and non-DM patients. We also investigated the differences in clinical backgrounds and questionnaire scores among DM patients with normal and abnormal manometry results. Results: A higher prevalence of esophageal motility disorder was observed in DM patients (60%, 21/35) compared to non-DM patients (29.6%, 16/54) (p = 0.001). The prevalence of minor disorders such as ineffective esophageal motor disorder and fragmented peristalsis was significantly higher (45 vs. 11%), and the distal contractile integral, integrated relaxation pressure, and contractile front velocity values were lower in the DM group. Among DM patients, those with abnormal esophageal motility had a significantly higher prevalence of neuropathy, retinopathy, and nephropathy, as well as higher reflux or constipation scores on the GSRS, than those with normal results. Conclusions: Among patients with dysphagia, the frequency of minor esophageal motility disorders was higher in DM patients than in non-DM patients. Abnormal esophageal motility related to poor esophageal clearance was associated with higher prevalence of diabetic complications.

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Section: Discussion/conclusionmentioning

confidence: 62%

Section: Methodsmentioning

confidence: 99%

Comparison of High-Resolution Manometry in Patients Complaining of Dysphagia among Patients with or without Diabetes Mellitus

et al. 2020

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“…Subsequent investigations using the Sandhill‐Unisensor solid‐state pressure sensor system, 10,11 and Laborie‐MMS‐Unisensor solid‐state pressure system identified similar or lower cut‐offs for the DCI 95th percentile, even when other pressure cut‐offs (eg, the 4 s‐Integrated Relaxation Pressure) were higher for the MMS system 12 . A Japanese study using the Starlet system coupled with Unisensor catheter showed higher DCI values compared to the ManoScan system, but again the highest individual value did not exceed 8000 mmHg · s · cm 13 . Therefore, the 8000 mmHg · s · cm threshold was retained for all manometry systems in the CCv4.0.…”

Section: Resultsmentioning

confidence: 92%

“…12 A Japanese study using the Starlet system coupled with Unisensor catheter showed higher DCI values compared to the ManoScan system, but again the highest individual value did not exceed 8000 mmHg•s•cm. 13 Therefore, the 8000 mmHg•s•cm threshold was retained for all manometry systems in the CCv4.0.…”

Section: Key Pointsmentioning

confidence: 99%

Chicago Classification Update (v4.0): Technical review on diagnostic criteria for hypercontractile esophagus

Chen

Savarino

Smout

et al. 2021

Neurogastroenterology Motil

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Hypercontractile esophagus (HE), defined by the Chicago Classification version 3.0 (CCv3.0) as 20% or more hypercontractile peristalsis (Distal Contractile Integral >8000 mmHg•s•cm) on high-resolution manometry (HRM), is a heterogeneous disorder with variable clinical presentations and natural course, leading to management challenges. An update on the diagnostic criteria for clinically relevant HE was needed.Literature on HE was extensively reviewed by the HE subgroup of the Chicago Classification version 4.0 (CCv4.0) Working Group and statements relating to the diagnosis of HE were ranked according to the RAND UCLA Appropriateness methodology by the Working Group, and the quality of evidence was rated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) framework.An overall emphasis of the CCv4.0 is on clinically relevant esophageal dysmotility, and thus it is recommended that an HE diagnosis requires both conclusive manometric diagnosis and clinically relevant symptoms of dysphagia and non-cardiac chest pain.The Working Group also recognized the subtypes of HE, including single-peaked, multi-peaked contractions (Jackhammer esophagus), and hypercontractile lower esophageal sphincter. However, there are no compelling data currently for formally subdividing HE to these subgroups in clinical practice. K E Y W O R D SChicago Classification, dysphagia, hypercontractile esophagus, jackhammer esophagus, noncardiac chest pain How to cite this article: Chen JW, Savarino E, Smout A, et al.Chicago Classification Update (v4.0): Technical review on diagnostic criteria for hypercontractile esophagus.

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“…However, in the early recovery phase, there is a demand for recommending HRM, in consideration of the safety of medical staff and patients. (1)(2)(3)(4) Based on the available evidence, we are proposing the following statements regarding HRM in consideration of the current situation of COVID-19.…”

mentioning

confidence: 99%

Statements for conducting high-resolution manometry during the COVID-19 pandemic

Mori

Tack

Suzuki

2020

J. Clin. Biochem. Nutr.

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To ensure the safety of medical personnel is important during the new coronavirus infectious disease (COVID-19) pandemic. Although high-resolution manometry (HRM) is an essential device for diagnosis of functional gastrointestinal disorders, it contains risks of droplet infection, contact infection and aerosol-borne infection. Screening tests such as PCR, serology test to detect COVID-19 antibodies, and CT scan should be considered as well as body temperature check and anamnestic risk assessment. Moreover, the provision of protective equipment such as a mask with face shield (or goggles + mask), gloves, cap or hairnet, and a long-sleeved gown would be necessary to reduce the risk of COVID-19.

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Clinical impact of different cut-off values in high-resolution manometry systems on diagnosing esophageal motility disorders

Cited by 29 publications

References 8 publications

Comparison of High-Resolution Manometry in Patients Complaining of Dysphagia among Patients with or without Diabetes Mellitus

Comparison of High-Resolution Manometry in Patients Complaining of Dysphagia among Patients with or without Diabetes Mellitus

Chicago Classification Update (v4.0): Technical review on diagnostic criteria for hypercontractile esophagus

Statements for conducting high-resolution manometry during the COVID-19 pandemic

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