論文

国際誌
2020年10月9日

Characterization of intragastric pressure waveform in Endoscopic Pressure Study Integrated System: a novel diagnostic device for gastroesophageal reflux disease.

Digestive endoscopy : official journal of the Japan Gastroenterological Endoscopy Society
  • Yuto Shimamura
  • ,
  • Haruhiro Inoue
  • ,
  • Enrique Rodriguez de Santiago
  • ,
  • Mary Raina Angeli Abad
  • ,
  • Yusuke Fujiyoshi
  • ,
  • Akiko Toshimori
  • ,
  • Mayo Tanabe
  • ,
  • Kazuya Sumi
  • ,
  • Yugo Iwaya
  • ,
  • Haruo Ikeda
  • ,
  • Manabu Onimaru

記述言語
英語
掲載種別
研究論文(学術雑誌)
DOI
10.1111/den.13867

OBJECTIVES: Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastroscopy. Based on previous data, EPSIS could diagnose GERD with good accuracy by assessing IGP waveform pattern. This study aimed to further characterize the waveform to improve the diagnostic yield of EPSIS. METHODS: We conducted a retrospective analysis of patients with typical GERD symptoms who underwent both EPSIS and 24-hour impedance-pH monitoring (MII-pH) at a single tertiary referral center from October 2018 to May 2020. EPSIS was performed by using a through-the-scope catheter connected to the pressure measuring system (TR-W550, TR-TeH08, AP-C35; Keyence, Osaka, Japan) to monitor IGP. Abnormal acid reflux was defined as acid exposure time (AET) over 6.0%. Pressure waveform was characterized as follows: a) Basal IGP, b) Maximum IGP, c) Pressure difference, d) Gradient of the waveform. RESULTS: A total of 57 patients with GERD symptoms were analyzed. Twenty-one patients presented abnormal AET on MII-pH. Among EPSIS parameters, pressure difference during insufflation correlated with AET (ρ= -0.66, p<0.001) and showed the best diagnostic accuracy for AET with the cut-off value of 8.0 mmHg (AUC 0.87). The gradient of EPSIS waveform also revealed good diagnostic accuracy for abnormal AET with the cut-off value of 0.11 mmHg/sec (AUC 0.81). CONCLUSIONS: EPSIS waveform parameters, especially pressure difference, presented high diagnostic accuracy for the presence of abnormal acid reflux.

リンク情報
DOI
https://doi.org/10.1111/den.13867
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/33037693
ID情報
  • DOI : 10.1111/den.13867
  • PubMed ID : 33037693

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