PMID- 34378104
OWN - NLM
STAT- MEDLINE
DCOM- 20220328
LR  - 20220401
IS  - 1612-9067 (Electronic)
IS  - 1612-9059 (Linking)
VI  - 19
IP  - 1
DP  - 2022 Jan
TI  - Ineffective esophageal motility in Chicago Classification version 4.0 better 
      predicts abnormal acid exposure.
PG  - 197-203
LID - 10.1007/s10388-021-00867-5 [doi]
AB  - BACKGROUND: The updated Chicago Classification version 4.0 (CCv4.0) establishes a 
      more stringent criteria to diagnose ineffective esophageal motility (IEM). This 
      study aims to investigate the clinical significance of IEM in CCv4.0 in the 
      context of gastroesophageal reflux disease (GERD). METHODS: A retrospective study 
      was conducted among suspected GERD patients who had heartburn and/or 
      regurgitation as their chief complaints and completed esophageal function tests 
      in our center from 2017 to 2019. Patients were further grouped as "CCv3.0 IEM" 
      and normal motility according to Chicago Classification version 3.0 (CCv3.0), and 
      as "CCv4.0 IEM" and normal motility according to CCv4.0. The clinical 
      characteristics, high-resolution manometry, esophageal reflux monitoring, and 
      proton pump inhibitor (PPI) efficacy were compared between different groups. 
      Multivariate analyses were performed to identify esophageal motility parameters 
      associated with reflux burden and symptom outcome. RESULTS: Of 172 subjects 
      included, 93 patients were identified as CCv3.0 IEM, 69 as CCv4.0 IEM. IEM in 
      either version was concomitant with elevated acid burden and impaired esophageal 
      clearance as compared to normal motility in corresponding diagnostic criteria, 
      while the only presence of IEM in CCv4.0 was predictive to abnormal acid exposure 
      (AET > 6%: OR = 2.66, 95% CI [1.27-5.56], p < 0.01). The presence of "CCv3.0 IEM" 
      and low EGJ-CI (EGJ-CI < 39.1 mmHg.cm) had no added value in predicting increased 
      reflux burden. No interaction effect was found between the presence of IEM and a 
      weakened EGJ. None of the manometric variables was capable of predicting PPI 
      response. CONCLUSIONS: Stringent criteria of IEM in CCv4.0 can better predict 
      abnormal acid exposure as compared to CCv3.0.
CI  - (c) 2021. The Japan Esophageal Society.
FAU - Zhuang, Qian-Jun
AU  - Zhuang QJ
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China.
FAU - Tan, Nian-di
AU  - Tan ND
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China.
FAU - Zhang, Meng-Yu
AU  - Zhang MY
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China.
FAU - Chen, Song-Feng
AU  - Chen SF
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China.
FAU - Luo, Yu
AU  - Luo Y
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China.
FAU - Xiao, Ying-Lian
AU  - Xiao YL
AD  - Department of Gastroenterology, The First Affiliated Hospital of Sun Yat-Sen 
      University, 58 Zhongshan II Road, Guangzhou, 510080, China. 
      xyingl@mail.sysu.edu.cn.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210810
PL  - Japan
TA  - Esophagus
JT  - Esophagus : official journal of the Japan Esophageal Society
JID - 101206627
SB  - IM
MH  - *Esophageal Motility Disorders
MH  - *Gastroesophageal Reflux/complications/diagnosis
MH  - Heartburn/complications
MH  - Humans
MH  - Manometry
MH  - Retrospective Studies
OTO - NOTNLM
OT  - Esophageal motility disorders
OT  - Gastroesophageal reflux
OT  - Manometry
EDAT- 2021/08/12 06:00
MHDA- 2022/03/29 06:00
CRDT- 2021/08/11 06:54
PHST- 2021/04/15 00:00 [received]
PHST- 2021/07/29 00:00 [accepted]
PHST- 2021/08/12 06:00 [pubmed]
PHST- 2022/03/29 06:00 [medline]
PHST- 2021/08/11 06:54 [entrez]
AID - 10.1007/s10388-021-00867-5 [pii]
AID - 10.1007/s10388-021-00867-5 [doi]
PST - ppublish
SO  - Esophagus. 2022 Jan;19(1):197-203. doi: 10.1007/s10388-021-00867-5. Epub 2021 Aug 
      10.