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

Rogers BD 1 , Rengarajan A 1 , Abrahao L 2 , Bhatia S 3 , Bor S 4 , Carlson DA 5 Show all authors , Cisternas D 6 , Gonlachanvit S 7 , Hani A 8 , Hayat J 9 , Kawamura O 10 , Lee YY 11 , Leguizamo AM 8 , Pauwels A 12 , Perez de la Serna J 13 , Ramos RI 14 , Remes-Troche JM 15 , Roman S 16 , Savarino E 17 , Serra J 18 , Sifrim D 19 , Tolone S 20 , Wong Z 21 , Zerbib F 22 , Pandolfino J 5 , Gyawali CP 1

Affiliations 

  • 1 Division of Gastroenterology, Washington University School of Medicine, St Louis, MO, USA
  • 2 University Hospital Clementino Fraga Filho, Rio de Janeiro, Brazil
  • 3 Department of Gastroenterology, Sir HN Reliance Foundation Hospital, Mumbai, India
  • 4 Department of Gastroenterology, Ege University, Izmir, Turkey
  • 5 Division of Gastroenterology and Hepatology, Northwestern University, Chicago, IL, USA
  • 6 Clínica Alemana de Santiago, Facultad de Medicina, Universidad del Desarrollo, Santiago de Chile, Chile
  • 7 Center of Excellence on Neurogastroenterology and Motility, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
  • 8 Departamento de Gastroenterología y Laboratorio de Motilidad, Hospital Universitario San Ignacio, Pontificia Universidad Javeriana, Bogotá, Colombia
  • 9 Department of Gastroenterology, St. George's University Hospitals NHS Trust, London, UK
  • 10 Department of Gastroenterology, Kamimoku SPA Hospital, Minakami, Gunma, Japan
  • 11 School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu, Malaysia
  • 12 Department of Gastroenterology, Catholic University of Leuven, Leuven, Belgium
  • 13 Unidad de Motilidad, Servicio de Aparto Digestivo, Hospital Clinico San Carlos, Madrid, Spain
  • 14 Motility Lab, Department of Gastroenterology, British Hospital and El Cruce Hospital, Buenos Aires, Argentina
  • 15 Digestive Physiology and Motility Lab, Medical Biological Research Institute, Universidad Veracruzana, Veracruz, México
  • 16 Digestive Physiology, Hospices Civils de Lyon, Hopital E Herriot, Université de Lyon, Lyon, France
  • 17 Division of Gastroenterology, Department of Surgery, Oncology and Gastroenterology, University of Padua, Padua, Italy
  • 18 Motility and Functional Gut Disorders Unit, University Hospital Germans Trias I Pujol. CIBERehd, Badalona, Barcelona, Spain
  • 19 Upper GI Physiology Unit, Barts and the London School of Medicine and Dentistry, London, UK
  • 20 General, Mininvasive and Bariatric Surgery Unit, University of Campania Luigi Vanvitelli, Naples, Italy
  • 21 Gut Research Group, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
  • 22 CHU de Bordeaux, Centre Medico-Chirurgical Magellan, Hôpital Haut-Lévêque, Gastroenterology Department, Université de Bordeaux, Bordeaux, France
Neurogastroenterol Motil, 2021 06;33(6):e14009.
PMID: 33094875 DOI: 10.1111/nmo.14009

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.

RESULTS: Of 484 studies (28.0 years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ-CI was similar between Medtronic (37.0 mm Hg cm, IQR 23.6-53.7 mm Hg cm) and Diversatek (34.9 mm Hg cm, IQR 22.1-56.1 mm Hg cm, P = 0.87), but was significantly higher using Laborie equipment (56.5 mm Hg cm, IQR 35.0-75.3 mm Hg cm, P 

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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