Esophagogastric junction morphology and contractile integral on high‐resolution manometry in asymptomatic healthy volunteers: An international multicenter study

Abstract

Background: Esophagogastric junction contractile integral (EGJ-CI) and EGJ morphology are high-resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited.Methods: Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ-CI was calculated by the same two investigators using a distal contractile integral-like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg cm), using manufacturer-specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ-CI values were calculated across age, genders, HRM systems, and regions.

Esophageal motility disorders on high‐resolution manometry: Chicago classification version 4.0©

“…(Strong Recommendation). While not met with agreement, it was suggested that an EGJ‐CI (or LES‐contractile integral) value of <25 mmHg•cm be considered a hypotensive EGJ 77–85 LES‐CD separation should be scored as the distance between the center of the CD and LES signal during inspiration, unless obscured in which case the LES position should be scored at expiration (Strong Recommendation). The EGJ complex should be defined based on LES‐CD separation and location of the RIP.…”

“…25,76 13 potensive EGJ. [77][78][79][80][81][82][83][84][85] • LES-CD separation should be scored as the distance between the center of the CD and LES signal during inspiration, unless obscured in which case the LES position should be scored at expiration (Strong Recommendation).…”

Reference high‐resolution manometry values after magnetic sphincter augmentation

“…The reproducibility of LES length measurement may be influenced by inter‐observer and technology variability in different laboratories. Recently, Rogers et al 22 published normative EGJ metrics in a large cohort of healthy volunteers. Taking into account only the Medtronic group, that is, the same technology used in our laboratory, the median EGJ‐CI and LES length were 37 mmHg cm and 3.7 cm, respectively.…”

Alteraciones de la motilidad esofágica en la manometría de alta resolución: Clasificación de Chicago versión 4.0©

“…− La EGJ-CI (integral contráctil del esfínter esofágico inferior) debe referenciarse a la presión intragástrica y debe expresarse en unidades de mmHg•cm (recomendación fuerte). Aunque no cumplió con el nivel de acuerdo, se sugirió que con un valor de EGJ-CI <25 mmHg•cm se considere la EGJ hipotensa [78][79][80][81][82][83][84][85][86] . − La separación LES-CD debería puntuarse como la distancia entre el centro del CD y la señal del LES durante la inspiración, a menos que esté oculta.…”