Table 2.
Contractile activity after treatment and relationship with HRM and FLIP EGJ opening parameters in the entire cohort, in the subgroup with ‘normal EGJ’ metrics and with ‘abnormal EGJ’ metrics (IRP <15 mmHg and normal EGJ opening classification on FLIP).
| Entire cohort | Normal EGJ subgroup | Abnormal EGJ subgroup | ||||
|---|---|---|---|---|---|---|
| No contractility | Contractility present | No contractility | Contractility present | No contractility | Contractility present | |
| N | 61 | 61 | 20 | 33 | 41 | 28 |
| Post-treatment HRM | ||||||
| IRP, mmHg, median (IQR) | 13 (10–20) | 12 (9–16) | 11 (8–13) | 10 (7–14) | 17 (11–21) | 17 (12–21) |
| DCI, mmHg∙s∙cm, median (IQR) | 0 (0–0) | 297 (183–545) | 0 (0–0) | 278 (180–471) | 0 (0–0) | 415 (196–697) |
| % swallows with DCI > 100, median (IQR) | 0 (0–0) | 80 (50–100) | - | - | - | - |
| Contractility pattern, n (%) | ||||||
| Normal | 0 | 5 (8) | 0 | 4 (6) | 0 | 5 (18) |
| Ineffective | 0 | 42 (69) | 0 | 20 (67) | 0 | 18 (64) |
| Absent | 61 (100) | 0 | 20 (100) | 0 | 41 (100) | 0 |
| Premature | 0 | 14 (23) | 0 | 9 (27) | 0 | 5 (18) |
| Post-treatment FLIP | ||||||
| 60ml pressure, mmHg, median (IQR) | 25 (21–31) | 29 (24–33) | 23 (20–28) | 29 (25–32) | 26 (21–33) | 29 (24–36) |
| Max EGJ diameter, mm, median (IQR) | 16 (13–18) | 17 (16–19) | 17 (17–19) | 18 (17–20) | 14 (13–16) | 16 (14–18) |
| EGJ-DI, mm2/mmHg, median (IQR) | 4.3 (2.6–6.6) | 5.0 (3.5–6.1) | 6.6 (4.5–7.1) | 5.8 (4.8–6.8) | 3.3 (2.3–4.7) | 3.5 (2.4–5.0) |
| Contractile response pattern, n (%) | ||||||
| Normal | 0 | 0 | 0 | 0 | 0 | 0 |
| Borderline | 0 | 3 (5) | 0 | 1 (3) | 0 | 2 (7) |
| Impaired-disordered | 36 (59) | 43 (70) | 13 (65) | 26 (79) | 24 (59) | 17 (61) |
| Absent | 23 (38) | 10 (16) | 7 (35) | 5 (15) | 16 (39) | 5 (18) |
| Spastic-reactive | 1 (2) | 5 (8) | 0 | 1 (3) | 1 (2) | 4 (14) |
| EGJ opening classification, n (%) | ||||||
| Normal | 30 (49) | 42 (69) | 20 (100) | 33 (100) | 10 (24) | 9 (32) |
| Borderline-normal | 10 (16) | 14 (23) | - | - | 10 (24) | 14 (50) |
| Borderline-reduced | 14 (23) | 4 (7) | - | - | 14 (35) | 4 (14) |
| Reduced | 7 (12) | 1 (2) | - | - | 7 (17) | 1 (4) |
| Normal + Borderline-normal | 40 (66) | 56 (92) | - | - | 20 (40) | 25 (89) |
| Reduced + Borderline-reduced | 21 (34) | 5 (8) | - | - | 21 (42) | 5 (18) |
| Post-treatment TBE | ||||||
| 1-minute column height, cm, median (IQR) | 8 (5–12) | 4 (0–8) | 7 (5–10) | 4 (0–7) | 8 (5–13) | 5 (0–12) |
| 5-minute column height, cm, median (IQR) | 6 (2–9) | 0 (0–4) | 5 (2–7) | 0 (0–3) | 7 (2–11) | 0 (0–7) |
| 5-minute column height <5cm, n (%) | 25 (40) | 48 (78) | 10 (50) | 28 (88) | 15 (37) | 20 (71) |
| Esophageal width, cm (IQR) | 2.9 (2.0–3.5) | 2.1 (1.7–2.7) | 2.6 (1.6–3.1) | 1.8 (1.7–2.3) | 3.2 (2.3–3.9) | 2.3 (1.8–3.0) |
| Symptoms | n=52 | n=55 | n=16 | n=30 | n=36 | n=25 |
| Eckardt score, median (IQR) | 3 (1–4) | 2 (1–3) | 2 (1–4) | 2 (1–4) | 3 (2–4) | 2 (1–3) |
| Eckardt score ≤3, n (%) | 33 (63) | 43 (78) | 11 (68) | 22 (73) | 22 (61) | 21 (84) |
Comparisons with significant (p<0.05) differences are marked in bold.
IRP: integrated relaxation pressure, EGJ: esophagogastric junction; EGJ-DI: esophagogastric junction distensibility index, TBE: timed barium esophagram, HRM: high-resolution-manometry, DCI: distal contractile integral, FLIP: functional luminal imaging probe.