Key result
Simple mean nocturnal baseline impedance strongly correlates with conventional analysis above the lower esophageal sphincter.
Why the study?
Current methodology for calculation of mean nocturnal baseline impedance (MNBI) is time-consuming and subject to operator-dependent selection bias, necessitating a simplified and more objective method.
Does a simple MNBI analysis correlate with conventional MNBI analysis in patients undergoing MII-pH monitoring?
Case-Control (n=100)
Single-blind
No
Does a simple MNBI analysis correlate with conventional MNBI analysis in patients undergoing MII-pH monitoring?
Effect estimate: r = 0.95
p-value: p=<0.001
A simplified method for calculating mean nocturnal baseline impedance provides values highly correlated with conventional analysis, offering a less time-consuming approach.
May streamline MNBI assessment in MII-pH monitoring; leaves open prospective validation before routine clinical adoption.
Background/AimsMean nocturnal baseline impedance (MNBI) during multichannel intraluminal impedance pH-monitoring (MII-pH) reflects the status of esophageal mucosal integrity.MNBI is suggested as an adjunctive method to distinguish patients with true gastroesophageal reflux disease (GERD) from functional heartburn (FH) and might predict outcomes for anti-reflux treatment.However, current methodology for calculation of MNBI is time-consuming and subject to operator-dependent selection bias.We aim to simplify and provide a more objective method to calculate MNBI. MethodsWe retrospectively analyzed 100 MII-pH tracings from 20 patients with erosive reflux disease, 20 with non-erosive reflux disease (NERD), 20 with reflux hypersensitivity, 20 with functional heartburn (FH), and 20 healthy asymptomatic volunteers.We compared the current "conventional" MNBI analysis with our "simple" MNBI analysis measured by selecting the whole supine period using the impedance average calculation function in the MII-pH software. ResultsAbsolute values were very similar and there was a strong correlation between conventional and simple MNBI values in the most distal channel in all groups (r ≥ 0.8, P < 0.001) including patients with increased supine acid reflux.Distal esophageal simple MNBI negatively correlated with acid exposure time (r = -0.695,P < 0.001).Patients with erosive reflux disease and NERD had lower simple MNBI values in the most distal channel compared to other groups (P < 0.001).With a cutoff value of 1785 ohms, simple MNBI can discriminate patients with GERD from those with reflux hypersensitivity and FH (sensitivity 80.0% and specificity 89.7%). ConclusionSimple MNBI analysis provides very similar values and has an excellent correlation with conventional MNBI analysis.
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Hoshikawa et al. (2020) conducted a case-control in Gastroesophageal reflux disease (GERD) (n=100). Simple mean nocturnal baseline impedance (MNBI) analysis vs. Conventional MNBI analysis was evaluated on Correlation between conventional and simple MNBI values at 3 cm above the lower esophageal sphincter (r = 0.95, p=<0.001). Simple mean nocturnal baseline impedance analysis strongly correlated with conventional analysis at 3 cm above the lower esophageal sphincter (r = 0.95, P < 0.001).
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