Storonova O., Makushina A., Paraskevova A., Trukhmanov A., Ivashkin V. Analysis of PSPW index is consider as a method for evaluat. the effectiv. of esophageal clearance and the criterion for phenotyping of GERD. Neurogastroenterol Motil. 2019;31;96:P.87

Analysis of postreflux swallow-induced peristaltic wave index is consider as a method for evaluating the effectiveness of esophageal clearance and the criterion for phenotyping of gastroesophageal reflux disease

Storonova Olga, Makushina Anastasiia, Paraskevova Anna, Trukhmanov Alexander, Ivashkin Vladimir

Sechenov University, Moscow, Russia

Постерный доклад на Конгрессе "NeuroGastro 2019" (Лиссабон, Португалия, 5-7 сентября 2019 г.)

Objective: absent contractility and minor motility disorders of esophagus cause poor clearance and aggravate the course of GERD. The impedance metric postreflux swallow-induced peristaltic wave (PSPW) index was proposed to evaluate esophageal clearance, motility efficiency as well as motility abnormalities. Our aim was to determine correlation between PSPW-index and parameters of high-resolution manometry (HRM) characterizing esophageal clearance. To evaluate PSPW-index* as a criterion for phenotyping of GERD.

Methods 60 GERD mean age 44,7(19-71)years (30 ERD, 30 NERD) and 20 healthy volunteers (45,2(26-65)years)) underwent HRM with 22-channel water-perfused catheter (Solar GI MMS, The Netherlands) and 24-hour multichannel intraluminal impedance-pH monitoring. We analyzed PSPW-index, distal contractile integral (DCI), peristaltic break. The statistical analysis was done using Statistica for Windows10.0 (StatSoft Inc.).

Results: PSPW-index and DCI values decrease with more severe course of GERD (r= - 0,4;p=0,0002; r= -0,49; p=0,000 respectively). Statistically significant difference between PSPW-index (p=0,02), DCI (p= 0,001) and peristaltic break (p=0,028) medians among ERD, NERD and control were observed. In the whole GERD group significant correlations between PSPW-index and DCI, and peristaltic break (r= 0,337; p=0,0091, r= - 0,269; p=0,038 respectively) were determined. In NERD correlation was revealed between PSPW-index and DCI (r= 0,378; p=0,04). In ERD group correlations did’t achieve a statistically significant level.

In NERD PSPW-index, DCI, peristaltic break medians were 0,56 [0,51;0,75], 565 [346,0;816,0] mmHg*s*cm, 2,95 [1,7; 5,0]cm respectively. In ERD: 0,23 [0,17;0,33], 249 [109,0;676,0], 4,8 [1,8;5,9]. In control group: 0,42 [0,3;0,5], 1040,5 [650,0;1722,0], 1,9 [0,85;3,55].

Conclusion: correlation between PSPW index and HRM-parameters characterizing impaired esophageal clearance (DCI, peristaltic break) allows to consider that PSPW index can be used as a criterion for evaluating the effectiveness of esophageal clearance. A decrease in the level of these parameters reflects the likelihood of a more severe course of the disease and can be used as additional criteria for phenotyping of GERD.

*Abnormal value: PSPW-index<61% [Frazzoni M et al.Clin Gastroenterol Hepatol.2016] or 0,61 in absolute.

To cite: O. Storonova, A. Makushina, A. Paraskevova, A. Trukhmanov, V. Ivashkin. Analysis of postreflux swallow-induced peristaltic wave index is consider as a method for evaluating the effectiveness of esophageal clearance and the criterion for phenotyping of gastroesophageal reflux disease. Neurogastroenterology & Motility, 2019; 31;  96: P.87, PFR 112:e13671.