Person: Cisternas, Daniel
Loading...
Email Address
Birth Date
Research Projects
Organizational Units
Job Title
Last Name
Cisternas
First Name
Daniel
Name
2 results
¿Qué estás buscando?
Search Results
Now showing 1 - 2 of 2
Publication High-resolution manometry thresholds and motor patterns among asymptomatic individuals.(2022) Rengarajan, Arvind; Rogers, Benjamin D.; Wong, Zhiqin; Tolone, Salvatore; Sifrim, Daniel; Serra, Jordi; Savarino, Edoardo; Roman, Sabine; Remes-Troche, Jose M.; Ramos, Rosa; Perez de la Serna, Julio; Pauwels, Ans; Leguizamo, Ana Maria; Yeh Lee, Yeong; Kawamura, Osamu; Hayat, Jamal; Hani, Albis; Gonlachanvit, Sutep; Cisternas, Daniel; Cisternas, Daniel; Carlson, Dustin; Bor, Serhat; Bhatia, Shobna; Abrahao, Luiz; Pandolfino, John; Gyawali, C. PrakashObjective: High-resolution manometry (HRM) is the current standard for characterization of esophageal body and esophagogastric junction (EGJ) function. We aimed to examine the prevalence of abnormal esophageal motor patterns in health, and to determine optimal thresholds for software metrics across HRM systems. Design: Manometry studies from asymptomatic adults were solicited from motility centers worldwide, and were manually analyzed using integrated relaxation pressure (IRP), distal latency (DL), and distal contractile integral (DCI) in standardized fashion. Normative thresholds were assessed using fifth and/or 95th percentile values. Chicago Classification v3.0 criteria were applied to determine motor patterns across HRM systems, study positions (upright vs supine), ages, and genders. Results: Of 469 unique HRM studies (median age 28.0, range 18-79 years). 74.6% had a normal HRM pattern; none had achalasia. Ineffective esophageal motility (IEM) was the most frequent motor pattern identified (15.1% overall), followed by EGJ outflow obstruction (5.3%). Proportions with IEM were lower using stringent criteria (10.0%), especially in supine studies (7.1%-8.5%). Other motor patterns were rare (0.2%-4.1% overall) and did not vary by age or gender. DL thresholds were close to current norms across HRM systems, while IRP thresholds varied by HRM system and study position. Both fifth and 95th percentile DCI values were lower than current thresholds, both in upright and supine positions. Conclusions: Motor abnormalities are infrequent in healthy individuals and consist mainly of IEM, proportions of which are lower when using stringent criteria in the supine position. Thresholds for HRM metrics vary by HRM system and study position.Publication Demographic and Manometric Variables Can Independently Predict Gastroesophageal Reflux Disease: The AGES-D Score(2025) Reyes, Diego; Muñoz, Ana; Candia, Roberto; Rey, Paula; Chahuan, Javier; Gran, Ignacio; Remes-Troche, José; Cisternas, Daniel; Monrroy, HugoObjective: Conclusive diagnosis of gastroesophageal reflux disease (GERD) can be challenging. When reflux monitoring is inconclusive, high-resolution esophageal manometry (HRM) may provide additional relevant information. We aimed to identify demographic and manometric parameters associated with GERD and to propose a diagnostic score. Methods: Adult patients with GERD symptoms who underwent reflux monitoring and HRM were considered for inclusion. The gold standard for GERD diagnosis was acid exposure time (AET); patients with AET>6% and AET<4% were included. Univariate and multivariate analyses were performed. A diagnostic score was developed using parameters independently associated with GERD. Generation and validation cohorts were randomly selected in a 2:1 ratio. Diagnostic accuracy was assessed using the area under the receiver operating characteristic curve (AUC ROC). Results: A total of 391 patients met the inclusion criteria; 167 had GERD (AET>6%) and 224 did not have GERD (AET<4%). In the multivariate analysis, age, male sex, and the distance between the lower esophageal sphincter and the crural diaphragm (LES-CD) were directly associated with GERD, while esophagogastric junction contractile integral (EGJ-CI) and distal contractile integral (DCI) were inversely associated with GERD (p values: 0.03, <0.01, <0.01, 0.01, and 0.01, respectively). The AUC ROC of a diagnostic score based on these parameters was 0.76 and 0.82 in the generation and validation cohorts, respectively. Conclusions: In this observational study, age, male sex, LES-CD distance, EGJ-CI, and DCI (AGES-D) were independently associated with GERD. A novel score incorporating these parameters could be useful in the assessment of inconclusive cases.