Propagation Characteristics of Fasting Duodeno-Jejunal Contractions in Healthy Controls Measured by Clustered Closely-spaced Manometric Sensors
Baker Jason R, Dickens Joseph R, Koenigsknecht Mark, Frances Ann, Lee Allen A, Shedden Kerby A, Brasseur James G, Amidon Gordon L, Sun Duxin, Hasler William L,
소속 상세정보
( Baker Jason R )
University of Michigan Health System Division of Gastroenterology
( Dickens Joseph R )
University of Michigan School of Pharmacy
( Koenigsknecht Mark )
University of Michigan School of Pharmacy
( Frances Ann )
University of Michigan School of Pharmacy
( Lee Allen A )
University of Michigan Health System Division of Gastroenterology
( Shedden Kerby A )
University of Michigan School of Pharmacy
( Brasseur James G )
University of Colorado Boulder Department of Aerospace Engineering Sciences
( Amidon Gordon L )
University of Michigan School of Pharmacy
( Sun Duxin )
University of Michigan School of Pharmacy
( Hasler William L )
University of Michigan Health System Division of Gastroenterology
Abstract
Background/Aims: High-resolution methods have advanced esophageal and anorectal manometry interpretation but are incompletely established for intestinal manometry. We characterized normal fasting duodeno-jejunal manometry parameters not measurable by standard techniques using clustered closely-spaced recordings.
Methods: Ten fasting recordings were performed in 8 healthy controls using catheters with 3?4 gastrointestinal manometry clusters with 1?2 cm channel spacing. Migrating motor complex phase III characteristics were quantified. Spatial-temporal contour plots measured propagation direction and velocity of individual contractions. Coupling was defined by pressure peak continuity within clusters.
Results: Twenty-three phase III complexes (11 antral, 12 intestinal origin) with 157 (95% CI, 104?211) minute periodicities, 6.99 (6.25?7.74) minute durations, 10.92 (10.68?11.16) cycle/minute frequencies, 73.6 (67.7?79.5) mmHg maximal amplitudes, and 4.20 (3.18?5.22) cm/minute propagation velocities were recorded. Coupling of individual contractions was 39.1% (32.1?46.1); 63.0% (54.4?71.6) of contractions were antegrade and 32.8% (24.1?41.5) were retrograde. Individual phase III contractions propagated > 35 fold faster (2.48 cm/sec; 95% CI, 2.25?2.71) than complexes themselves. Phase III complexes beyond the proximal jejunum were longer in duration (P = 0.025) and had poorer contractile coupling (P = 0.025) than proximal complexes. Coupling was greater with 1 cm channel spacing vs 2 cm (P < 0.001).
Conclusions: Intestinal manometry using clustered closely-spaced pressure ports characterizes novel antegrade and retrograde propagation and coupling properties which degrade in more distal jejunal segments. Coupling is greater with more closely-spaced recordings. Applying similar methods to dysmotility syndromes will define the relevance of these methods.
키워드
Intestines; Manometry; Migrating; Muscle contraction; Myoelectric complex
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