Relationship between esophageal muscle thickness and intraluminal pressure in patients with esophageal spasm

American Journal of Physiology - Gastrointestinal and Liver Physiology - Tập 282 Số 6 - Trang G1016-G1023 - 2002
Nonko Pehlivanov1,2, Jianmin Liu1,2, Ghassan S. Kassab1,2, Cheryl Beaumont1,2, Ravinder K. Mittal1,2
1Department of Bioengineering, University of California, San Diego, La Jolla, California, 92093-0412
2Division of Gastroenterology, University of California San Diego, San Diego Veterans Affairs Medical Center, San Diego, 92161; and Department of Bioengineering, University of California San Diego, La Jolla, California 92093-0412

Tóm tắt

We previously showed, in normal subjects, a positive correlation between the esophageal contraction amplitude and peak muscle thickness. The goal of this study was to determine the relationship between esophageal muscle thickness and contraction amplitude in patients with high-amplitude peristaltic and simultaneous contractions. Eleven patients with high-amplitude peristaltic contractions, 8 with diffuse esophageal spasm (DES), 7 with nonspecific (NS) motor disorder of the esophagus, and 10 normal subjects were studied using simultaneous pressure and ultrasound imaging. Pressure was recorded by manometry and ultrasound imaging with a high-frequency ultrasound probe catheter. Recordings were performed in the lower esophageal sphincter (LES) and at 2, 4, 6, 8, and 10 cm above the LES during resting state and swallow-induced contractions. Baseline esophageal muscle was thicker in the distal, compared with the proximal esophagus both in normal subjects and patient groups. Patients with DES and nutcracker esophagus (NC) have a higher baseline muscle thickness compared with normal and NS patients. Correlation between the peak pressure and the peak muscle thickness was weaker in patients with NC and DES compared with normal subjects and patients with NS. Whereas normal subjects have good correlation between delta (difference between peak and baseline) muscle thickness and peak pressures, this relationship was absent in patients with NC and DES. Increase in contraction amplitude in patients with NC and DES was associated with an increase in baseline thickness of esophageal muscularis propria. Increase in baseline thickness was specific to patients with spastic motor disorders and was not seen in patients with NS.

Từ khóa


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Thông tin xuất bản

American Journal of Physiology - Gastrointestinal and Liver Physiology

Tập 282 Số 6

G1016-G1023

Thông tin tác giả