Esophageal wall compliance/stiffness during peristalsis in patients with functional dysphagia and high-amplitude esophageal contractions.
Esophageal wall compliance/stiffness during peristalsis in patients with functional dysphagia and high-amplitude esophageal contractions.
复制标题
功能性吞咽困难和食管高强度收缩患者蠕动期间食管壁顺应性/僵硬。
DOI：
10.1152/ajpgi.00075.2022
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Mittal,RavinderK
中科院分区：
文献类型：
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作者：
Zifan,Ali;Gandu,Vignesh;Mittal,RavinderK
最近利用扩张/收缩图研究食管狭窄的研究显示，功能性吞咽困难和高振幅收缩[高振幅食管收缩（HAEC）]患者的食管扩张不良，即使这些患者的食管狭窄收缩期正常。我们的目标是确定原发性食管炎期间功能性吞咽困难和HAEC患者食管壁的生物力学特性和团注流特性。对30名健康受试者、30名功能性吞咽困难患者和25名HAEC患者进行了研究。受试者以头低脚高位吞下10 mL 0.5 N生理盐水推注，以研究原发性乳房炎。定制软件（Dplots）根据阻抗测量值、峰值扩张时的压力、壁张力（压力×半径）、壁扩张性[横截面积（CSA）/压力]和四个食管段（上下食管括约肌之间）的推注流量（cm 3/s）确定峰值扩张。功能性吞咽困难和HAEC患者食管远端管腔CSA较小，平均推注流速较快。与正常人相比，两组患者的食管壁扩张性（食管壁顺应性的测量）较低，而食管壁张力较高。超声成像证实食管扩张不良。与正常人相比，功能性吞咽困难患者在扩张峰值时有更大的壁厚趋势。一个僵硬的或非顺应性的食管壁的原因是穷人的扩张食管在原发性pronecsis在功能性吞咽困难和HAEC.NEW &值得注意的是，我们研究了健康的无症状的主题，功能性吞咽困难（FD）患者，和患者高振幅食管收缩（HAEC）。我们的数据显示，与正常受试者相比，HAEC和功能性吞咽困难患者的管腔扩张较小（峰值扩张时管腔CSA较低），管腔内压力较高，液体团通过食管的速度更快。我们的结论是，功能性吞咽困难和HAEC患者有一个更硬的远端食管壁在丸运输相关的原发性食管炎。
Recent studies that utilized distension/contraction plots to study peristalsis reveal poor distension of the esophagus in patients with functional dysphagia and high-amplitude contractions [high-amplitude esophageal contractions (HAECs)] even though the contraction phase of peristalsis is normal in these patients. Our goal was to determine biomechanical properties of the esophageal wall and bolus flow characteristics in patients with functional dysphagia and HAEC during primary peristalsis. Studies were performed on 30 healthy subjects, 30 patients with functional dysphagia, and 25 patients with HAEC. Subjects swallowed 10 mL, 0.5 N saline bolus in the Trendelenburg position to study primary peristalsis. A custom-built software (Dplots) determined peak distension from the impedance measurements, pressure at peak distension, wall tension (pressure × radius), wall distensibility [cross-sectional area (CSA)/pressure], and bolus flow (cm3/s) in four segments of esophagus (between upper and lower esophageal sphincter). Luminal CSA of distal esophagus was smaller, and average bolus flow rate was faster in patients with functional dysphagia and HAEC. Esophageal wall distensibility, a measure of esophageal wall compliance was lower and wall tension was higher in the distal esophagus of both patient groups compared with normal subjects. Ultrasound imaging confirmed poor distension of the esophagus. A trend toward greater wall thickness at the peak of distension was found in patients with functional dysphagia compared with normal subjects. A stiffer or noncompliant esophageal wall is the reason for poor distension of the esophagus during primary peristalsis in patients with functional dysphagia and HAEC.NEW & NOTEWORTHYWe studied healthy asymptomatic subject, patients with functional dysphagia (FD), and patients with high-amplitude esophageal contractions (HAEC). Our data show that in patients with HAEC and functional dysphagia, luminal distension is smaller (low luminal CSA at peak distension), intraluminal pressure is higher, and liquid bolus travels faster through the esophagus as compared with normal subjects. We conclude that patients with functional dysphagia and HAEC have a stiffer distal esophageal wall during bolus transport related to primary peristalsis.