Chaotic peak propagation in patients with Jackhammer esophagus

Yinglian Xiao*, Dustin A. Carlson, Zhiyue Lin, John E. Pandolfino

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: The contractile activity of Jackhammer esophagus(JE) is heterogeneous and abnormalities in the balance of pre- and post-peak contractile activity has been reported. We observed that the progression of the peak contraction is disordered in JE patients, which reflect underlying abnormalities in the inhibitory and excitatory influence in esophageal contraction. In order to better define this abnormality, we developed novel time metrics to define trajectory of the pressure wave peak and assessed it in healthy controls and JE patients. Methods: 38 patients with JE (ages 43-70, 19 females) and 71 asymptomatic controls (ages 19-48; 33 females) were retrospectively evaluated. High resolution manometry was performed in all subjects with 10 supine liquid swallows. The first 5 intact supine swallows and supine swallow with the greatest DCI were analyzed using ManoView™ software and customized MATLAB program. The time distance, negative time distance sum and chaotic ratio were calculated. JE patients were subcategorized by the Brief Esophageal Dysphagia Questionnaire (BEDQ) with cut-off of 6. Key results: Jackhammer patients had longer time distance, longer negative time distance, and higher chaotic ratio than controls(p < 0.001). The distribution of the number of negative time distances differed between JE patients with BEDQ>6 and BEDQ≤6. Conclusions & Inferences: The trajectory of the pressure wave peak propagation commonly occurred in an unordered fashion in JE, but rarely in controls. Additionally, differences in pressure propagation trajectory was associated with higher symptom scores thus trajectory of the pressure wave peak may be an important marker of abnormal esophageal motor function.

Original languageEnglish (US)
Article numbere13725
JournalNeurogastroenterology and Motility
Volume32
Issue number1
DOIs
StatePublished - Jan 1 2020

Fingerprint

Esophagus
Swallows
Pressure
Manometry
Deglutition
Deglutition Disorders
Software

Keywords

  • Jackhammer esophagus
  • chaotic
  • high-resolution manometry
  • peak pressure

ASJC Scopus subject areas

  • Physiology
  • Endocrine and Autonomic Systems
  • Gastroenterology

Cite this

@article{d4892ee10b8b43c4b3f53d36685cec82,
title = "Chaotic peak propagation in patients with Jackhammer esophagus",
abstract = "Background: The contractile activity of Jackhammer esophagus(JE) is heterogeneous and abnormalities in the balance of pre- and post-peak contractile activity has been reported. We observed that the progression of the peak contraction is disordered in JE patients, which reflect underlying abnormalities in the inhibitory and excitatory influence in esophageal contraction. In order to better define this abnormality, we developed novel time metrics to define trajectory of the pressure wave peak and assessed it in healthy controls and JE patients. Methods: 38 patients with JE (ages 43-70, 19 females) and 71 asymptomatic controls (ages 19-48; 33 females) were retrospectively evaluated. High resolution manometry was performed in all subjects with 10 supine liquid swallows. The first 5 intact supine swallows and supine swallow with the greatest DCI were analyzed using ManoView™ software and customized MATLAB program. The time distance, negative time distance sum and chaotic ratio were calculated. JE patients were subcategorized by the Brief Esophageal Dysphagia Questionnaire (BEDQ) with cut-off of 6. Key results: Jackhammer patients had longer time distance, longer negative time distance, and higher chaotic ratio than controls(p < 0.001). The distribution of the number of negative time distances differed between JE patients with BEDQ>6 and BEDQ≤6. Conclusions & Inferences: The trajectory of the pressure wave peak propagation commonly occurred in an unordered fashion in JE, but rarely in controls. Additionally, differences in pressure propagation trajectory was associated with higher symptom scores thus trajectory of the pressure wave peak may be an important marker of abnormal esophageal motor function.",
keywords = "Jackhammer esophagus, chaotic, high-resolution manometry, peak pressure",
author = "Yinglian Xiao and Carlson, {Dustin A.} and Zhiyue Lin and Pandolfino, {John E.}",
year = "2020",
month = "1",
day = "1",
doi = "10.1111/nmo.13725",
language = "English (US)",
volume = "32",
journal = "Neurogastroenterology and Motility",
issn = "1350-1925",
publisher = "Wiley-Blackwell",
number = "1",

}

Chaotic peak propagation in patients with Jackhammer esophagus. / Xiao, Yinglian; Carlson, Dustin A.; Lin, Zhiyue; Pandolfino, John E.

In: Neurogastroenterology and Motility, Vol. 32, No. 1, e13725, 01.01.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Chaotic peak propagation in patients with Jackhammer esophagus

AU - Xiao, Yinglian

AU - Carlson, Dustin A.

AU - Lin, Zhiyue

AU - Pandolfino, John E.

PY - 2020/1/1

Y1 - 2020/1/1

N2 - Background: The contractile activity of Jackhammer esophagus(JE) is heterogeneous and abnormalities in the balance of pre- and post-peak contractile activity has been reported. We observed that the progression of the peak contraction is disordered in JE patients, which reflect underlying abnormalities in the inhibitory and excitatory influence in esophageal contraction. In order to better define this abnormality, we developed novel time metrics to define trajectory of the pressure wave peak and assessed it in healthy controls and JE patients. Methods: 38 patients with JE (ages 43-70, 19 females) and 71 asymptomatic controls (ages 19-48; 33 females) were retrospectively evaluated. High resolution manometry was performed in all subjects with 10 supine liquid swallows. The first 5 intact supine swallows and supine swallow with the greatest DCI were analyzed using ManoView™ software and customized MATLAB program. The time distance, negative time distance sum and chaotic ratio were calculated. JE patients were subcategorized by the Brief Esophageal Dysphagia Questionnaire (BEDQ) with cut-off of 6. Key results: Jackhammer patients had longer time distance, longer negative time distance, and higher chaotic ratio than controls(p < 0.001). The distribution of the number of negative time distances differed between JE patients with BEDQ>6 and BEDQ≤6. Conclusions & Inferences: The trajectory of the pressure wave peak propagation commonly occurred in an unordered fashion in JE, but rarely in controls. Additionally, differences in pressure propagation trajectory was associated with higher symptom scores thus trajectory of the pressure wave peak may be an important marker of abnormal esophageal motor function.

AB - Background: The contractile activity of Jackhammer esophagus(JE) is heterogeneous and abnormalities in the balance of pre- and post-peak contractile activity has been reported. We observed that the progression of the peak contraction is disordered in JE patients, which reflect underlying abnormalities in the inhibitory and excitatory influence in esophageal contraction. In order to better define this abnormality, we developed novel time metrics to define trajectory of the pressure wave peak and assessed it in healthy controls and JE patients. Methods: 38 patients with JE (ages 43-70, 19 females) and 71 asymptomatic controls (ages 19-48; 33 females) were retrospectively evaluated. High resolution manometry was performed in all subjects with 10 supine liquid swallows. The first 5 intact supine swallows and supine swallow with the greatest DCI were analyzed using ManoView™ software and customized MATLAB program. The time distance, negative time distance sum and chaotic ratio were calculated. JE patients were subcategorized by the Brief Esophageal Dysphagia Questionnaire (BEDQ) with cut-off of 6. Key results: Jackhammer patients had longer time distance, longer negative time distance, and higher chaotic ratio than controls(p < 0.001). The distribution of the number of negative time distances differed between JE patients with BEDQ>6 and BEDQ≤6. Conclusions & Inferences: The trajectory of the pressure wave peak propagation commonly occurred in an unordered fashion in JE, but rarely in controls. Additionally, differences in pressure propagation trajectory was associated with higher symptom scores thus trajectory of the pressure wave peak may be an important marker of abnormal esophageal motor function.

KW - Jackhammer esophagus

KW - chaotic

KW - high-resolution manometry

KW - peak pressure

UR - http://www.scopus.com/inward/record.url?scp=85073957382&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073957382&partnerID=8YFLogxK

U2 - 10.1111/nmo.13725

DO - 10.1111/nmo.13725

M3 - Article

C2 - 31532046

AN - SCOPUS:85073957382

VL - 32

JO - Neurogastroenterology and Motility

JF - Neurogastroenterology and Motility

SN - 1350-1925

IS - 1

M1 - e13725

ER -