The Esophageal and Swallowing Center, Division of Gastroenterology and Hepatology, Case Western Reserve University, MetroHealth Medical Center, Cleveland, OH, USA.
Neurogastroenterol Motil. 2018 Jun;30(6):e13282. doi: 10.1111/nmo.13282. Epub 2017 Dec 29.
High-resolution esophageal manometry (HREM) has become a leading tool in the assessment of esophageal motor disorders, replacing conventional manometry. However, there is limited data about the contribution of HREM as compared with conventional manometry to the assessment of esophageal motor disorders in patients with non-cardiac chest pain (NCCP). The aim of the study was to compare the distribution of esophageal motor disorders in patients with NCCP using HREM as compared with conventional manometry and to determine if HREM improved diagnosis of these disorders.
In this study, we included 300 consecutive patients with NCCP who underwent either HREM or conventional manometry over a period of 10 years. A total of 150 patients had conventional manometry and the other 150 patients HREM. The Chicago 3.0 classification and the Castell and Spechler classification were used to determine the esophageal motor disorder of NCCP patients undergoing HREM and conventional manometry, respectively.
In both HREM and the conventional manometry groups, normal esophageal motility was the most frequent finding (47% and 36%; respectively, P = .054). Hypotensive lower esophageal sphincter was the most common motility disorder identified by conventional manometry (27.3%), while ineffective esophageal motility was the most common esophageal motor disorder identified by HREM (25.3%).
CONCLUSIONS & INFERENCES: There is a discrepancy in the type of esophageal motor disorders identified by HREM as compared with conventional manometry in NCCP patients. Hypotensive motility disorders are the most commonly diagnosed by both manometric techniques.
高分辨率食管测压（HREM）已成为评估食管动力障碍的主要工具，取代了传统测压法。然而，关于 HREM 与传统测压法相比在非心源性胸痛（NCCP）患者食管动力障碍评估中的作用的相关数据有限。本研究旨在比较 HREM 与传统测压法在 NCCP 患者中食管动力障碍的分布，并确定 HREM 是否能改善这些疾病的诊断。
在这项研究中，我们纳入了 300 例连续的 NCCP 患者，他们在 10 年内接受了 HREM 或传统测压法。其中 150 例患者进行了传统测压法，另 150 例患者进行了 HREM。采用芝加哥 3.0 分类和卡斯特尔和斯佩克勒分类分别确定 HREM 和传统测压法下 NCCP 患者的食管动力障碍。
在 HREM 和传统测压组中，正常食管动力均为最常见的发现（分别为 47%和 36%；P=0.054）。传统测压法中最常见的动力障碍是低压力性下食管括约肌，而 HREM 中最常见的食管动力障碍是无效食管动力（分别为 27.3%和 25.3%）。
在 NCCP 患者中，HREM 与传统测压法识别的食管动力障碍类型存在差异。两种测压技术均最常诊断出动力低下的运动障碍。
