Title: T1136 Nonsteroidal Anti-Inflammatory Drugs Alter Lateral Distribution Within Epithelial Cell Plasma Membrane
Abstract: BACKGROUND AND AIM:The addition of multichannel intraluminal impedance to 24h pH monitoring of esophageal reflux strives to improve the diagnostic yield of the test, but is partly limited by the complexity of interpreting of the resultant tracing data.To simplify detection of reflux events, recent modifications to analysis software now include color contour algorithms that use color intensity to indicate impedance change.We aimed to assess the effect of the color contour display on the diagnostic yield of impedance monitoring.METHODS: The 24-h impedance-pH recordings of 20 consecutive patients (7M, 26 -83 years, 12 studied on proton pump inhibitor (PPI) therapy) were visually evaluated using two display modes offered by the analysis software (Medical Measurement Systems).First, reflux was tracked using impedance tracings alone by marking retrograde drops in impedance propagating at least two impedance segments proximal to the lower esophageal sphincter.The recordings were then re-assessed with impedance color contours superimposed over the tracings.The marked reflux events were modified based on distal-toproximal retrograde bolus motion evident from the impedance color contours.The symptom association probability (SAP) was calculated for each analysis method.Meal periods and gas reflux events were excluded.RESULTS: Superimposed impedance color contours increased the number of reflux events detected in 15 patients (75 %; 1 -15 more events detected), decreased detection in 4 patients (20 %; 1 -6 fewer events detected), and caused no change in 1 patient.Overall, there was an increase from a median of 38 (25 th -75 th percentile: 28 -53) to a median of 49 (25 th -75 th percentile: 31 -53) (p = 0.007).Contours were most helpful during and directly after swallows, re-reflux, gradual impedance drops, rapid reflux events and those occurring amidst a fluctuating impedance signal.However, the contour algorithm did not detect reflux during periods with high baseline impedance values.The contour re-analysis revealed an abnormal number of reflux events (> 58, 75 th percentile normal) in 2 patients otherwise judged normal, both studied on PPI therapy.The SAP was not altered by contour re-analysis.CONCLUSION: Superimposing color contours over impedance line tracings subtly altered the detection of reflux events.Our experience suggests that these display modalities are complimentary and, used together, may increase the diagnostic accuracy of 24-h impedance-pH reflux monitoring.
Publication Year: 2010
Publication Date: 2010-04-28
Language: en
Type: article
Indexed In: ['crossref']
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Cited By Count: 1
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