Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve

A. Mauro, E. Savarino, N. De Bortoli, S. Tolone, D. Pugliese, M. Franchina, C. P. Gyawali, R. Penagini

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Background: Multiple rapid swallows (MRS) is a provocative test for assessment of contraction reserve, however reproducibility on repetitive MRS is incompletely understood. Our aim was to determine the optimal number of MRS sequences for consistent assessment of contraction reserve. Methods: One hundred and fifty-nine consecutive patients (79 IEM and 80 normal motility) who underwent high-resolution manometers were enrolled. Ten single swallows (SS) and 10 MRS were performed. Gold standard for evaluation of the contraction reserve was the ratio between the mean DCI of 10 MRS and the mean DCI of 10 SS (MRS/SS DCI ratio). Rates of false negatives and false positives were calculated for increasing numbers of MRS sequences, using either mean DCI or the MRS with the highest DCI. Key Results: According to the gold standard, 50 IEM and 50 normal motility patients had contraction reserve. With progressively increasing numbers of MRS sequences, contraction reserve was detected using mean MRS DCI within three and four MRS sequences in IEM and normal motility respectively, whereas two and three MRS sequences were needed using the MRS sequence with the highest DCI. False positives were much higher with highest DCI method compared with mean DCI, (22% vs 9% respectively in IEM; 24% vs 9% in normal motility) when three MRS sequences were considered. Conclusions & Inferences: At least three MRS are needed to reliably assess contraction reserve. The mean DCI of the three MRS sequences is the best variable to utilize as evidence of contraction reserve.

Original languageEnglish
Pages (from-to)e13253
JournalNeurogastroenterology and Motility
Volume30
Issue number4
DOIs
Publication statusPublished - 2018

Fingerprint

Swallows
Manometry
Aurothioglucose

Keywords

  • Contraction reserve
  • High resolution manometry
  • Ineffective esophageal motility
  • Multiple rapid swallows

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve. / Mauro, A.; Savarino, E.; De Bortoli, N.; Tolone, S.; Pugliese, D.; Franchina, M.; Gyawali, C. P.; Penagini, R.

In: Neurogastroenterology and Motility, Vol. 30, No. 4, 2018, p. e13253.

Research output: Contribution to journalArticle

Mauro, A. ; Savarino, E. ; De Bortoli, N. ; Tolone, S. ; Pugliese, D. ; Franchina, M. ; Gyawali, C. P. ; Penagini, R. / Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve. In: Neurogastroenterology and Motility. 2018 ; Vol. 30, No. 4. pp. e13253.
@article{45a6214ee76b457698ce23f81c67f5f9,
title = "Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve",
abstract = "Background: Multiple rapid swallows (MRS) is a provocative test for assessment of contraction reserve, however reproducibility on repetitive MRS is incompletely understood. Our aim was to determine the optimal number of MRS sequences for consistent assessment of contraction reserve. Methods: One hundred and fifty-nine consecutive patients (79 IEM and 80 normal motility) who underwent high-resolution manometers were enrolled. Ten single swallows (SS) and 10 MRS were performed. Gold standard for evaluation of the contraction reserve was the ratio between the mean DCI of 10 MRS and the mean DCI of 10 SS (MRS/SS DCI ratio). Rates of false negatives and false positives were calculated for increasing numbers of MRS sequences, using either mean DCI or the MRS with the highest DCI. Key Results: According to the gold standard, 50 IEM and 50 normal motility patients had contraction reserve. With progressively increasing numbers of MRS sequences, contraction reserve was detected using mean MRS DCI within three and four MRS sequences in IEM and normal motility respectively, whereas two and three MRS sequences were needed using the MRS sequence with the highest DCI. False positives were much higher with highest DCI method compared with mean DCI, (22{\%} vs 9{\%} respectively in IEM; 24{\%} vs 9{\%} in normal motility) when three MRS sequences were considered. Conclusions & Inferences: At least three MRS are needed to reliably assess contraction reserve. The mean DCI of the three MRS sequences is the best variable to utilize as evidence of contraction reserve.",
keywords = "Contraction reserve, High resolution manometry, Ineffective esophageal motility, Multiple rapid swallows",
author = "A. Mauro and E. Savarino and {De Bortoli}, N. and S. Tolone and D. Pugliese and M. Franchina and Gyawali, {C. P.} and R. Penagini",
year = "2018",
doi = "10.1111/nmo.13253",
language = "English",
volume = "30",
pages = "e13253",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",
number = "4",

}

TY - JOUR

T1 - Optimal number of multiple rapid swallows needed during high-resolution esophageal manometry for accurate prediction of contraction reserve

AU - Mauro, A.

AU - Savarino, E.

AU - De Bortoli, N.

AU - Tolone, S.

AU - Pugliese, D.

AU - Franchina, M.

AU - Gyawali, C. P.

AU - Penagini, R.

PY - 2018

Y1 - 2018

N2 - Background: Multiple rapid swallows (MRS) is a provocative test for assessment of contraction reserve, however reproducibility on repetitive MRS is incompletely understood. Our aim was to determine the optimal number of MRS sequences for consistent assessment of contraction reserve. Methods: One hundred and fifty-nine consecutive patients (79 IEM and 80 normal motility) who underwent high-resolution manometers were enrolled. Ten single swallows (SS) and 10 MRS were performed. Gold standard for evaluation of the contraction reserve was the ratio between the mean DCI of 10 MRS and the mean DCI of 10 SS (MRS/SS DCI ratio). Rates of false negatives and false positives were calculated for increasing numbers of MRS sequences, using either mean DCI or the MRS with the highest DCI. Key Results: According to the gold standard, 50 IEM and 50 normal motility patients had contraction reserve. With progressively increasing numbers of MRS sequences, contraction reserve was detected using mean MRS DCI within three and four MRS sequences in IEM and normal motility respectively, whereas two and three MRS sequences were needed using the MRS sequence with the highest DCI. False positives were much higher with highest DCI method compared with mean DCI, (22% vs 9% respectively in IEM; 24% vs 9% in normal motility) when three MRS sequences were considered. Conclusions & Inferences: At least three MRS are needed to reliably assess contraction reserve. The mean DCI of the three MRS sequences is the best variable to utilize as evidence of contraction reserve.

AB - Background: Multiple rapid swallows (MRS) is a provocative test for assessment of contraction reserve, however reproducibility on repetitive MRS is incompletely understood. Our aim was to determine the optimal number of MRS sequences for consistent assessment of contraction reserve. Methods: One hundred and fifty-nine consecutive patients (79 IEM and 80 normal motility) who underwent high-resolution manometers were enrolled. Ten single swallows (SS) and 10 MRS were performed. Gold standard for evaluation of the contraction reserve was the ratio between the mean DCI of 10 MRS and the mean DCI of 10 SS (MRS/SS DCI ratio). Rates of false negatives and false positives were calculated for increasing numbers of MRS sequences, using either mean DCI or the MRS with the highest DCI. Key Results: According to the gold standard, 50 IEM and 50 normal motility patients had contraction reserve. With progressively increasing numbers of MRS sequences, contraction reserve was detected using mean MRS DCI within three and four MRS sequences in IEM and normal motility respectively, whereas two and three MRS sequences were needed using the MRS sequence with the highest DCI. False positives were much higher with highest DCI method compared with mean DCI, (22% vs 9% respectively in IEM; 24% vs 9% in normal motility) when three MRS sequences were considered. Conclusions & Inferences: At least three MRS are needed to reliably assess contraction reserve. The mean DCI of the three MRS sequences is the best variable to utilize as evidence of contraction reserve.

KW - Contraction reserve

KW - High resolution manometry

KW - Ineffective esophageal motility

KW - Multiple rapid swallows

UR - http://www.scopus.com/inward/record.url?scp=85034645185&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85034645185&partnerID=8YFLogxK

U2 - 10.1111/nmo.13253

DO - 10.1111/nmo.13253

M3 - Article

AN - SCOPUS:85034645185

VL - 30

SP - e13253

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

IS - 4

ER -