Abstract
Objectives
We investigated the diagnostic utility of distal contractile integral (DCI) to esophageal impedance integral (EII) ratio (DCIIR) in high-resolution impedance manometry (HRIM) of ineffective esophageal motility (IEM) in children.
Methods
We performed HRIM in 31 children with dysphagia, odynophagia, chronic vomiting, chest pain, or heartburn sensation. Based on the Chicago classification version 3.0, 20 subjects were diagnosed with IEM, and 11 subjects were normal. We analyzed the EII and DCIIR using MATLAB software.
Results
The DCIIR calculated at the impedance cutoff at 1500 Ω (DCIIR1500) were significantly lower in IEM group than patients with normal motility (P = 0.007). Receiver operating characteristic (ROC) curve analysis showed that a DCIIR1500 < 0.009 mmHg/Ω best predicted IEM in children (P < 0.001). A DCIIR1500 < 0.008 mmHg/Ω is associated with significant body weight loss > 10% within 6 months in children. (P < 0.001).
Conclusions
The calculation of DCIIR1500 may assist the automatic analysis of bolus transit in HRIM study to diagnose IEM in children. An DCIIR1500 < 0.009 mmHg/Ω may assist in the diagnosis of IEM in children, and DCIIR1500 < 0.008 mmHg/Ω correlated with significant body weight loss. The calculation of DCIIR may serve as possible parameters for HRIM.
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Acknowledgements
This work is supported by Donation Grant FD105012 and a Grant from National Taiwan University Hospital (NTUH 107 P06).
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J-.F.W. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. J-.F.W. wrote the manuscript. J-.F.W.: study concept and design. J-.F.W., C.C., P-.H.T., I-.J.T., Y-.C.L., and C-.H.Y.: contribution to study design. J.-.F.W., C.C., Y-.C.L., and P-.H.T.: acquisition of data, and analysis and interpretation of data. J-.F.W.: drafting of the manuscript. J-.F.W., C.C., P-.H.T., Y-.C.L., I-.J.T., and C-.H.Y.: critical revision of the manuscript for important intellectual content. J-.F.W.: statistical analysis. C-.H.Y., C.C., Y-.C.L.,: administrative, technical support. J-.F.W., C-.H.Y., and I-.J.T.: obtained funding. J-.F.W. and C-.H.Y.: study supervision. J-.F.W., CC, C-.H.Y., Y-.C.L., P-.H.T., and I-.J.T.: decision to submit the paper for publication. All authors has seen and approved the submission of this version of the manuscript and takes full responsibility for the manuscript. All authors had final approval of the final version to be published, and agreement to be accountable for all aspects of the work in ensuring that questions related the accuracy or integrity of any part of the work are appropriately investigated and resolved.
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Wu, JF., Chung, C., Tseng, PH. et al. Distal contractile to impedance integral ratio assist the diagnosis of pediatric ineffective esophageal motility disorder. Pediatr Res 84, 849–853 (2018). https://doi.org/10.1038/s41390-018-0197-3
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DOI: https://doi.org/10.1038/s41390-018-0197-3
