Characterization of intragastric pressure waveform in endoscopic pressure study integrated system: Novel diagnostic device for gastroesophageal reflux disease
Objectives Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastrosco...
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| Veröffentlicht in: | Digestive endoscopy 2021-07, Vol.33 (5), p.780-787 |
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| creator | Shimamura, Yuto Inoue, Haruhiro Rodriguez de Santiago, Enrique Abad, Mary Raina Angeli Fujiyoshi, Yusuke Toshimori, Akiko Tanabe, Mayo Sumi, Kazuya Iwaya, Yugo Ikeda, Haruo Onimaru, Manabu |
| description | Objectives
Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastroscopy. Based on previous data, EPSIS could diagnose GERD with good accuracy by assessing IGP waveform pattern. This study aimed to further characterize the waveform to improve the diagnostic yield of EPSIS.
Methods
We conducted a retrospective analysis of patients with typical GERD symptoms who underwent both EPSIS and 24‐h impedance‐pH monitoring (MII‐pH) at a single tertiary referral center from October 2018 to May 2020. EPSIS was performed by using a through‐the‐scope catheter connected to the pressure measuring system (TR‐W550, TR‐TeH08, AP‐C35; Keyence, Osaka, Japan) to monitor IGP. Abnormal acid reflux was defined as acid exposure time (AET) over 6.0%. Pressure waveform was characterized as follows: (i) Basal IGP, (ii) Maximum IGP, (iii) Pressure difference, (iv) Gradient of the waveform.
Results
A total of 57 patients with GERD symptoms were analyzed. Twenty‐one patients presented abnormal AET on MII‐pH. Among EPSIS parameters, pressure difference during insufflation correlated with AET (ρ = −0.66, P |
| doi_str_mv | 10.1111/den.13867 |
| format | Article |
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Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastroscopy. Based on previous data, EPSIS could diagnose GERD with good accuracy by assessing IGP waveform pattern. This study aimed to further characterize the waveform to improve the diagnostic yield of EPSIS.
Methods
We conducted a retrospective analysis of patients with typical GERD symptoms who underwent both EPSIS and 24‐h impedance‐pH monitoring (MII‐pH) at a single tertiary referral center from October 2018 to May 2020. EPSIS was performed by using a through‐the‐scope catheter connected to the pressure measuring system (TR‐W550, TR‐TeH08, AP‐C35; Keyence, Osaka, Japan) to monitor IGP. Abnormal acid reflux was defined as acid exposure time (AET) over 6.0%. Pressure waveform was characterized as follows: (i) Basal IGP, (ii) Maximum IGP, (iii) Pressure difference, (iv) Gradient of the waveform.
Results
A total of 57 patients with GERD symptoms were analyzed. Twenty‐one patients presented abnormal AET on MII‐pH. Among EPSIS parameters, pressure difference during insufflation correlated with AET (ρ = −0.66, P < 0.01) and showed the best diagnostic accuracy for AET with the cutoff value of 4.7 mmHg (area under the curve [AUC], 0.87). The gradient of EPSIS waveform also revealed good diagnostic accuracy for abnormal AET with the cutoff value of 0.07 mmHg/s (AUC, 0.81).
Conclusions
Endoscopic pressure study integrated system waveform parameters, especially pressure difference, presented high diagnostic accuracy for the presence of abnormal acid reflux.</description><identifier>ISSN: 0915-5635</identifier><identifier>EISSN: 1443-1661</identifier><identifier>DOI: 10.1111/den.13867</identifier><identifier>PMID: 33037693</identifier><language>eng</language><publisher>Australia</publisher><subject>endoscopic diagnosis ; endoscopy ; esophagus ; gastroesophageal reflux disease</subject><ispartof>Digestive endoscopy, 2021-07, Vol.33 (5), p.780-787</ispartof><rights>2020 Japan Gastroenterological Endoscopy Society</rights><rights>This article is protected by copyright. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3497-7fcffb5f51a4c1af0bd24124463fec39954d315eaa09a52c0913fa3684be44673</citedby><cites>FETCH-LOGICAL-c3497-7fcffb5f51a4c1af0bd24124463fec39954d315eaa09a52c0913fa3684be44673</cites><orcidid>0000-0003-4773-8769 ; 0000-0002-2269-0132 ; 0000-0002-2852-6042 ; 0000-0002-5893-6552 ; 0000-0002-5860-9164 ; 0000-0003-4107-9264</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fden.13867$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fden.13867$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33037693$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shimamura, Yuto</creatorcontrib><creatorcontrib>Inoue, Haruhiro</creatorcontrib><creatorcontrib>Rodriguez de Santiago, Enrique</creatorcontrib><creatorcontrib>Abad, Mary Raina Angeli</creatorcontrib><creatorcontrib>Fujiyoshi, Yusuke</creatorcontrib><creatorcontrib>Toshimori, Akiko</creatorcontrib><creatorcontrib>Tanabe, Mayo</creatorcontrib><creatorcontrib>Sumi, Kazuya</creatorcontrib><creatorcontrib>Iwaya, Yugo</creatorcontrib><creatorcontrib>Ikeda, Haruo</creatorcontrib><creatorcontrib>Onimaru, Manabu</creatorcontrib><title>Characterization of intragastric pressure waveform in endoscopic pressure study integrated system: Novel diagnostic device for gastroesophageal reflux disease</title><title>Digestive endoscopy</title><addtitle>Dig Endosc</addtitle><description>Objectives
Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastroscopy. Based on previous data, EPSIS could diagnose GERD with good accuracy by assessing IGP waveform pattern. This study aimed to further characterize the waveform to improve the diagnostic yield of EPSIS.
Methods
We conducted a retrospective analysis of patients with typical GERD symptoms who underwent both EPSIS and 24‐h impedance‐pH monitoring (MII‐pH) at a single tertiary referral center from October 2018 to May 2020. EPSIS was performed by using a through‐the‐scope catheter connected to the pressure measuring system (TR‐W550, TR‐TeH08, AP‐C35; Keyence, Osaka, Japan) to monitor IGP. Abnormal acid reflux was defined as acid exposure time (AET) over 6.0%. Pressure waveform was characterized as follows: (i) Basal IGP, (ii) Maximum IGP, (iii) Pressure difference, (iv) Gradient of the waveform.
Results
A total of 57 patients with GERD symptoms were analyzed. Twenty‐one patients presented abnormal AET on MII‐pH. Among EPSIS parameters, pressure difference during insufflation correlated with AET (ρ = −0.66, P < 0.01) and showed the best diagnostic accuracy for AET with the cutoff value of 4.7 mmHg (area under the curve [AUC], 0.87). The gradient of EPSIS waveform also revealed good diagnostic accuracy for abnormal AET with the cutoff value of 0.07 mmHg/s (AUC, 0.81).
Conclusions
Endoscopic pressure study integrated system waveform parameters, especially pressure difference, presented high diagnostic accuracy for the presence of abnormal acid reflux.</description><subject>endoscopic diagnosis</subject><subject>endoscopy</subject><subject>esophagus</subject><subject>gastroesophageal reflux disease</subject><issn>0915-5635</issn><issn>1443-1661</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp1kc9u1DAQhy0EokvhwAsgH-GQ1o6dpOaGlvJHqsoFztGsPd4aJXHwONsuD8Oz4u0WxIW5-DDffGPNj7GXUpzJUucOpzOpLtruEVtJrVUl21Y-ZithZFM1rWpO2DOi70LI2mj9lJ0oJVTXGrViv9Y3kMBmTOEn5BAnHj0PU06wBcopWD4nJFoS8lvYoY9pLG2Ok4tk4_xvn_Li9odZ3CbI6DjtKeP4ll_HHQ7cBdhOkXIZcbgLFnmR8fstESnON7BFGHhCPyx3hSYEwufsiYeB8MXDe8q-fbj8uv5UXX35-Hn97qqySpuu6rz1ftP4RoK2ErzYuFrLWutWebTKmEY7JRsEEAaa2pbDKA-qvdAbLFCnTtnro3dO8ceClPsxkMVhgAnjQn1RGdPWRhzQN0fUpkhUvtvPKYyQ9r0U_SGOvsTR38dR2FcP2mUzovtL_rl_Ac6PwG0YcP9_U__-8vqo_A2M_Jl6</recordid><startdate>202107</startdate><enddate>202107</enddate><creator>Shimamura, Yuto</creator><creator>Inoue, Haruhiro</creator><creator>Rodriguez de Santiago, Enrique</creator><creator>Abad, Mary Raina Angeli</creator><creator>Fujiyoshi, Yusuke</creator><creator>Toshimori, Akiko</creator><creator>Tanabe, Mayo</creator><creator>Sumi, Kazuya</creator><creator>Iwaya, Yugo</creator><creator>Ikeda, Haruo</creator><creator>Onimaru, Manabu</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-4773-8769</orcidid><orcidid>https://orcid.org/0000-0002-2269-0132</orcidid><orcidid>https://orcid.org/0000-0002-2852-6042</orcidid><orcidid>https://orcid.org/0000-0002-5893-6552</orcidid><orcidid>https://orcid.org/0000-0002-5860-9164</orcidid><orcidid>https://orcid.org/0000-0003-4107-9264</orcidid></search><sort><creationdate>202107</creationdate><title>Characterization of intragastric pressure waveform in endoscopic pressure study integrated system: Novel diagnostic device for gastroesophageal reflux disease</title><author>Shimamura, Yuto ; Inoue, Haruhiro ; Rodriguez de Santiago, Enrique ; Abad, Mary Raina Angeli ; Fujiyoshi, Yusuke ; Toshimori, Akiko ; Tanabe, Mayo ; Sumi, Kazuya ; Iwaya, Yugo ; Ikeda, Haruo ; Onimaru, Manabu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3497-7fcffb5f51a4c1af0bd24124463fec39954d315eaa09a52c0913fa3684be44673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>endoscopic diagnosis</topic><topic>endoscopy</topic><topic>esophagus</topic><topic>gastroesophageal reflux disease</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shimamura, Yuto</creatorcontrib><creatorcontrib>Inoue, Haruhiro</creatorcontrib><creatorcontrib>Rodriguez de Santiago, Enrique</creatorcontrib><creatorcontrib>Abad, Mary Raina Angeli</creatorcontrib><creatorcontrib>Fujiyoshi, Yusuke</creatorcontrib><creatorcontrib>Toshimori, Akiko</creatorcontrib><creatorcontrib>Tanabe, Mayo</creatorcontrib><creatorcontrib>Sumi, Kazuya</creatorcontrib><creatorcontrib>Iwaya, Yugo</creatorcontrib><creatorcontrib>Ikeda, Haruo</creatorcontrib><creatorcontrib>Onimaru, Manabu</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Digestive endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shimamura, Yuto</au><au>Inoue, Haruhiro</au><au>Rodriguez de Santiago, Enrique</au><au>Abad, Mary Raina Angeli</au><au>Fujiyoshi, Yusuke</au><au>Toshimori, Akiko</au><au>Tanabe, Mayo</au><au>Sumi, Kazuya</au><au>Iwaya, Yugo</au><au>Ikeda, Haruo</au><au>Onimaru, Manabu</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Characterization of intragastric pressure waveform in endoscopic pressure study integrated system: Novel diagnostic device for gastroesophageal reflux disease</atitle><jtitle>Digestive endoscopy</jtitle><addtitle>Dig Endosc</addtitle><date>2021-07</date><risdate>2021</risdate><volume>33</volume><issue>5</issue><spage>780</spage><epage>787</epage><pages>780-787</pages><issn>0915-5635</issn><eissn>1443-1661</eissn><abstract>Objectives
Endoscopic pressure study integrated system (EPSIS) is a novel diagnostic tool for gastroesophageal reflux disease (GERD). EPSIS has been developed to evaluate lower esophageal sphincter function by monitoring the intragastric pressure (IGP) while insufflating the stomach during gastroscopy. Based on previous data, EPSIS could diagnose GERD with good accuracy by assessing IGP waveform pattern. This study aimed to further characterize the waveform to improve the diagnostic yield of EPSIS.
Methods
We conducted a retrospective analysis of patients with typical GERD symptoms who underwent both EPSIS and 24‐h impedance‐pH monitoring (MII‐pH) at a single tertiary referral center from October 2018 to May 2020. EPSIS was performed by using a through‐the‐scope catheter connected to the pressure measuring system (TR‐W550, TR‐TeH08, AP‐C35; Keyence, Osaka, Japan) to monitor IGP. Abnormal acid reflux was defined as acid exposure time (AET) over 6.0%. Pressure waveform was characterized as follows: (i) Basal IGP, (ii) Maximum IGP, (iii) Pressure difference, (iv) Gradient of the waveform.
Results
A total of 57 patients with GERD symptoms were analyzed. Twenty‐one patients presented abnormal AET on MII‐pH. Among EPSIS parameters, pressure difference during insufflation correlated with AET (ρ = −0.66, P < 0.01) and showed the best diagnostic accuracy for AET with the cutoff value of 4.7 mmHg (area under the curve [AUC], 0.87). The gradient of EPSIS waveform also revealed good diagnostic accuracy for abnormal AET with the cutoff value of 0.07 mmHg/s (AUC, 0.81).
Conclusions
Endoscopic pressure study integrated system waveform parameters, especially pressure difference, presented high diagnostic accuracy for the presence of abnormal acid reflux.</abstract><cop>Australia</cop><pmid>33037693</pmid><doi>10.1111/den.13867</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-4773-8769</orcidid><orcidid>https://orcid.org/0000-0002-2269-0132</orcidid><orcidid>https://orcid.org/0000-0002-2852-6042</orcidid><orcidid>https://orcid.org/0000-0002-5893-6552</orcidid><orcidid>https://orcid.org/0000-0002-5860-9164</orcidid><orcidid>https://orcid.org/0000-0003-4107-9264</orcidid></addata></record> |
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| subjects | endoscopic diagnosis endoscopy esophagus gastroesophageal reflux disease |
| title | Characterization of intragastric pressure waveform in endoscopic pressure study integrated system: Novel diagnostic device for gastroesophageal reflux disease |
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