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Transmitted cardiovascular pulsations on high resolution esophageal impedance manometry, and their significance in dysphagia

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World Journal of Gastroenterology 2017年第44期23卷 7840-7848页

作者： Naueen A Chaudhry Kamran Zahid Sara Keihanian Yunfeng Dai Qing Zhang Depart-ment of Medicine Division of GastroenterologyUniversity of Florida Department of Medicine Division of Hospital MedicineUniversity of Florida Department of Biostatistics University of Florida

AIM To investigate the behavior of pulsatile pressure zones(PPZ's) as noted on high resolution esophageal impedance manometry(HREIM), and determine their association with *** Retrospective, single center case control design scr-eening HREIM studies for cases(dysphagia) and controls(no dysphagia). Thoracic radiology studies were reviewed further in cases for(thoracic cardiovascular) thoracic cardiovascular(TCV) structures in esophageal proximity to compare with HREIM findings. Manometric data was collected for number, location, axial length, PPZ pressure and esophageal clearance function(impedance). RESULTS Among 317 screened patients, 56% cases and 64% controls had PPZ's. Fifty cases had an available thoracic radiology comparison. The distribution of PPZ's in these 50 cases and 59 controls was similar(average 1.4 PPZ/patient). Controls(mean 31.2 ± SD 12 years) were a significantly younger population than cases(mean 67.3 ± SD 14.9 years) with P 20%. CONCLUSION Transmitted TCV pulsations observed in HREIM bear no significant impact on swallowing. However, in older adults with dysphagia, evidence of impaired bolus clearance on impedance should be evaluated for external TCV compression. These associations have never been explored previously in literature, and are novel.

关键词： High resolution esophageal manometry Dysphagia Dysphagia lusoria Dysphagia cardia esophageal motility Thoracic cardiovascular structures esophageal disorders

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