Evidence map›Paper›PMID 35972282›Full record

ArticleNeurogastroenterology and motility2022

Type II achalasia with focal elevated pressures: A distinct manometric and clinical sub-group.

Eric E Low, Syed Abbas Fehmi, Aws Hasan, Michael Chang, Wilson Kwong, Mary L Krinsky, Gobind Anand, Madeline Greytak, Alexander Kaizer, Dustin A Carlson and 2 more

Registry-linked trialOpen access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurogastroenterology and motility, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT06883175 (Evolution of the Chicago Classification), which is not on this map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.3field-weighted citation impact, top 20% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT06883175 narecruitingnot on this mapstarted 2024, after this paper: background citation

Evolution of the Chicago Classification: Bridging Physiology and Mechanics

TypeinterventionalSponsorNorthwestern UniversityRan2024 to 2029Enrolled575ConditionsDysphagia, Achalasia, Esophageal, Ineffective Esophageal MotilityArmsFLIP, HRM, Prucalopride
3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 3 institutions in 1 country.

Eric E LowDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.ORCID 0000-0003-0852-8005
Syed Abbas FehmiDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Aws HasanDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Michael ChangDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Wilson KwongDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Mary L KrinskyDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Gobind AnandDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Madeline GreytakDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.
Alexander KaizerDepartment of Biostatistics & Informatics, University of Colorado, Denver, Colorado, USA.
Dustin A CarlsonDivision of Gastroenterology, Northwestern University, Chicago, Illinois, USA.
John E PandolfinoDivision of Gastroenterology, Northwestern University, Chicago, Illinois, USA.
Rena YadlapatiDivision of Gastroenterology, University of California San Diego, San Diego, California, USA.ORCID 0000-0002-7872-2033
University of California San Diego · USNorthwestern University · USUniversity of Colorado Denver · US

Funding

Training Grant in GastroenterologyT32DK007202 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA · 1985 to 2022
$7.7M
Role of altered response to volumetric distension in esophageal diseaseP01DK117824 · NIDDK · NORTHWESTERN UNIVERSITY AT CHICAGO · PI PANDOLFINO, JOHN E · 2018 to 2022
$7.3M
Mechanism Guided Therapy for Laryngopharyngeal RefluxK23DK125266 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI YADLAPATI, RENA HIREN · 2021 to 2025
$963k
NIDDK NIH HHS K23 DK125266NIDDK NIH HHS P01 DK117824NIDDK NIH HHS T32 DK007202
6 · The paper itself

Abstract

backgroundType II achalasia (Ach2) is distinguished from other achalasia sub-types by the presence of panesophageal pressurization (PEP) of ≥30 mmHg in ≥20% swallows on high-resolution manometry (HRM). Variable manometric features in Ach2 have been observed, characterized by focal elevated pressures (FEPs) (focal/segmental pressures ≥70 mmHg within the PEP band) and/or high compression pressures (PEP ≥70 mmHg). This study aimed to examine clinical and physiologic variables among sub-groups of Ach2.

methodsThis retrospective single center study performed over 3 years (1/2019-1/2022) included adults with Ach2 on HRM who underwent endoscopic ultrasound (EUS), functional lumen imaging probe (FLIP), and/or barium esophagram (BE) prior to therapy. Patients were categorized into two overarching sub-groups: Ach2 without FEPs and Ach2 with FEPs. Demographic, clinical, and physiologic data were compared between these sub-groups utilizing unpaired univariate analyses. KEY

resultsOf 53 patients with Ach2, 40 (75%) were without FEPs and 13 (25%) had FEPs. Compared with the Ach2 sub-group without FEPs, the Ach2 sub-group with FEPs demonstrated a significantly thickened distal esophageal circular muscle on EUS (1.4 mm [SD 0.9] vs. 2.1 [0.7]; p = 0.02), higher prevalence of tertiary contractions on BE (46% vs. 100%; p = 0.0006), lower esophagogastric junction distensibility index (2.2mm CONCLUSIONS AND INFERENCES: We identified a distinct sub-group of type II achalasia on HRM, defined as type II achalasia with focal elevated pressures. This sub-group uniquely exhibits spastic features and may benefit from personalized treatment approaches.

Indexed as

Esophageal AchalasiaAdultEsophagogastric JunctionHumansManometryRetrospective StudiesachalasiacontractionesophagusEUSmanometry

Identifiers

PMID35972282
PMCPMC9722506
OpenAlexW4292181731

What OpenQuestion holds

Textmetadata
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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.