Sustained esophageal contraction: A marker of esophageal chest pain identified by intraluminal ultrasonography
Sustained esophageal contraction: A marker of esophageal chest pain identified by intraluminal ultrasonography
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DOI：
10.1016/s0016-5085(99)70225-8
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发表时间：
1999-01-01
期刊：
影响因子：
29.4
通讯作者：
Mittal, RK
中科院分区：
文献类型：
--
作者：
Balaban, DH;Yamamoto, Y;Mittal, RK
背景与目的：腔内压力记录系统尚未证实不明原因胸痛与食管运动的相关性。本研究使用连续高频腔内超声检查来表征自发性和诱发性胸痛时的食管收缩。研究方法：在10名原因不明的胸痛受试者中记录了最多24小时的食管腔内压力、pH值和超声图像。测量食管肌肉厚度的变化作为肌肉收缩的标志。另外10名疑似食管胸痛的受试者在注射依酚氯铵后进行了研究，以激发症状，10名健康受试者作为对照，结果：24例自发性胸痛发作中有18例在超声检查中检测到持续的食管收缩（SEC）（平均持续时间，68.0秒），这种运动模式不伴有管腔内压力的变化，24个无症状对照期中有4个伴有SEC，尽管这些收缩的平均持续时间较短（29.0秒; P < 0.001）。在5名对依酚铵有阳性胸痛反应的受试者中观察到SEC，5名受试者中无一人有阴性反应。在正常人中未检测到SEC。结论：先前未被识别的食管运动事件SEC与自发性和诱发性食管胸痛之间存在强时间相关性。
Background & Aims: Intraluminal pressure recording systems have not demonstrated predictable esophageal motor correlates of unexplained chest pain. This study used continuous high-frequency intraluminal ultrasonography to characterize esophageal contraction at the time of spontaneous and provoked chest pain. Methods: Intraluminal pressure, pH, and ultrasound images of the esophagus were recorded for a maximum of 24 hours in 10 subjects with unexplained chest pain. Changes in esophageal muscle thickness were measured as a marker of muscle contraction. Ten additional subjects with suspected esophageal chest pain were studied after edrophonium chloride injection to provoke symptoms, Ten healthy subjects were studied as controls, Results: Eighteen of 24 spontaneous chest pain episodes were preceded by a sustained esophageal contraction (SEC) detected on ultrasonography (mean duration, 68.0 seconds), This motor pattern was not accompanied by changes in intraluminal pressure, Four of 24 asymptomatic control periods were accompanied by SEC, although these contractions were of shorter mean duration (29.0 seconds; P < 0.001). SEC was observed in 5 subjects with a positive chest pain response to edrophonium and in none of the 5 subjects with a negative response. SEC was not detected in normal subjects. Conclusions: There is a strong temporal correlation between a previously unrecognized esophageal motor event, SEC, and both spontaneous and provoked esophageal chest pain.