Distension‐evoked motility analysis in human esophagus

Liao, Donghua; Villadsen, Gerda Elisabeth; Gregersen, Hans

doi:10.1111/nmo.12081

Cited by 15 publications

(35 citation statements)

References 22 publications

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“…The work increased and propulsive tension increased with the distension pressure. Lower values were found during butylscopolamine administration compared with the distension before using the drug . Furthermore, tension–stretch ratio loops in patients with systemic sclerosis were shifted to the left, indicative of a stiffer wall in patients.…”

Section: Application Of Cardiac Muscle Concepts To the Esophagusmentioning

confidence: 92%

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Pathophysiology and treatment of achalasia in a muscle mechanical perspective

Gregersen

Lo²

2018

Annals of the New York Academy of Sciences

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This review provides a biomechanical perspective on the pathophysiology and treatment of achalasia. The esophagus is efficient in transporting ingested material to the stomach in healthy subjects. A fine balance exists between the peristaltic forces generated in the esophageal body (which herein is defined as the preload) and the resistance in the outlet, the esophago-gastric junction (which is defined as the afterload). Achalasia is a rare esophageal disease that progressively over many years challenges esophageal efficacy. Clinical features and current literature are interpreted using well-known muscle mechanics models and terms from cardiac mechanophysiology. The preload, afterload, length-tension, and strain softening concepts in particular are useful for understanding the remodeling induced by achalasia. The concepts are also useful in understanding the treatment that aim to reduce the lower esophageal sphincter pressure that does not relax sufficiently in achalasia. These treatments cover endoscopic or laparoscopic myotomy, pneumatic balloon dilation, and Botox injections. In addition to the intended reduction of the afterload for aboral transport of ingested materials, the treatments tend to induce gastroesophageal reflux in some patients because they obliterate an important component in the reflux barrier.

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Section: Application Of Cardiac Muscle Concepts To the Esophagusmentioning

confidence: 92%

“…These studies clearly demonstrated the usefulness of loop analysis. Force–velocity and force–power relations have been demonstrated in the normal and diseased esophagus. Hence, the velocity of contraction and the force depend on each other in a hyperbolic way …”

Section: Application Of Cardiac Muscle Concepts To the Esophagusmentioning

confidence: 99%

Pathophysiology and treatment of achalasia in a muscle mechanical perspective

Gregersen

Lo²

2018

Annals of the New York Academy of Sciences

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“…In esophagology, the field of muscle analysis is still in its infancy; in the future it may have an impact on the strategy for diagnosing esophageal disorders. Impedance planimetric muscle function analysis in the GI tract includes length–tension diagrams, force velocity curves, and preload–afterload and loop diagrams . Basically, the following information can be derived from such analysis: length–tension relationships force velocity curves preload–afterload analysis loop diagrams …”

Section: What Does Distension Reveal About Esophageal Efficacy and Nementioning

confidence: 99%

“…Combined with this, there is a strong resistance to lengthening an active muscle far beyond the peak of active tension. By using impedance planimetry in the GI tract, it has been possible to demonstrate passive as well as phasic and tonic active tension components …”

Section: What Does Distension Reveal About Esophageal Efficacy and Nementioning

confidence: 99%

“…For many muscles, the optimal shortening velocity for power generation is approximately one‐third of maximum shortening velocity. Force–velocity relationships have been demonstrated for esophageal muscle . The fundamental length–tension and force–velocity properties of muscle have numerous biomechanical consequences, including limiting contraction speed and strength.…”

Section: What Does Distension Reveal About Esophageal Efficacy and Nementioning

confidence: 99%

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Esophageal multimodal stimulation and sensation

Hoff

McMahon

Gregersen

2018

Annals of the New York Academy of Sciences

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Esophageal mechanosensation describes the relationship between a mechanical stimulation of the esophageal wall, such as bag distension, and the reaction to the stimulation perceived or unperceived. When studying mechanosensation in esophageal disease, it is important to recognize that symptoms might be due to alterations at different levels of the neuromuscular system, such as alterations at the mechanoreceptor level or in the afferent mechanosensory pathways, or irregularities in the homeostatic state. One might ask if it is possible to provoke, record, and describe the multidimensional responses behind a mechanosensory experience? It is a complex system and, at a minimum, a multidisciplinary approach is needed to avoid erroneous conclusions. The multimodal study design, taking the mode, location, and parameters of stimulation into consideration, together with controlled recording of assessment parameters, is an approach that seems rational and valid. Gastrointestinal (GI) physicians of the 21th century need to have knowledge of advances in the evaluation of GI mechanical function and what provokes symptoms. Hereby, it is possible to fully appreciate the slowly emerging awareness of how GI pain symptoms should be explored and explained to patients.

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Mechanical experimentation of the gastrointestinal tract: a systematic review

Durcan,

Hossain,

Chagnon

et al. 2023

Biomech Model Mechanobiol

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The gastrointestinal (GI) organs of the human body are responsible for transporting and extracting nutrients from food and drink, as well as excreting solid waste. Biomechanical experimentation of the GI organs provides insight into the mechanisms involved in their normal physiological functions, as well as understanding of how diseases can cause disruption to these. Additionally, experimental findings form the basis of all finite element (FE) modelling of these organs, which have a wide array of applications within medicine and engineering. This systematic review summarises the experimental studies that are currently in the literature (n = 247) and outlines the areas in which experimentation is lacking, highlighting what is still required in order to more fully understand the mechanical behaviour of the GI organs. These include (i) more human data, allowing for more accurate modelling for applications within medicine, (ii) an increase in time-dependent studies, and (iii) more sophisticated in vivo testing methods which allow for both the layer- and direction-dependent characterisation of the GI organs. The findings of this review can also be used to identify experimental data for the readers’ own constitutive or FE modelling as the experimental studies have been grouped in terms of organ (oesophagus, stomach, small intestine, large intestine or rectum), test condition (ex vivo or in vivo), number of directions studied (isotropic or anisotropic), species family (human, porcine, feline etc.), tissue condition (intact wall or layer-dependent) and the type of test performed (biaxial tension, inflation–extension, distension (pressure-diameter), etc.). Furthermore, the studies that investigated the time-dependent (viscoelastic) behaviour of the tissues have been presented.

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Distension‐evoked motility analysis in human esophagus

Cited by 15 publications

References 22 publications

Pathophysiology and treatment of achalasia in a muscle mechanical perspective

Pathophysiology and treatment of achalasia in a muscle mechanical perspective

Esophageal multimodal stimulation and sensation

Mechanical experimentation of the gastrointestinal tract: a systematic review

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