J Neurogastroenterol Motil  
The Relationship of the Post-reflux Swallow-induced Peristaltic Wave Index and Esophageal Baseline Impedance with Gastroesophageal Reflux Disease Symptoms
Young Kyu Cho,1 Joon Seong Lee,1* Tae Hee Lee,1 Su Jin Hong,2 Sang Joon Park,1 Seong Ran Jeon,1 Hyun Gun Kim,1 and Jin-Oh Kim1
1Department of Internal Medicine, College of Medicine, Soonchunhyang University Hospital, Seoul, Korea; and 2Department of Internal Medicine, Soonchunhyang University Hospital, Bucheon, Gyeonggi-do, Korea
Correspondence to: Joon Seong Lee, MD
Institute for Digestive Research, Soonchunhyang University College of Medicine, 59, Daesagwan-ro, Yongsan-gu, Seoul 04401, Korea
Tel: +82-2-709-9691 Fax: +82-2-709-9696, E-mail: joonlee@schmc.ac.kr
Received: July 15, 2016; Revised: July 18, 2016; Accepted: October 31, 2016; Published online: January 2, 2017.
© The Korean Society of Neurogastroenterology and Motility. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background/Aims
The post-reflux swallow-induced peristaltic wave (PSPW) index and esophageal baseline impedance (BI) are novel impedance parameters used to evaluate esophageal chemical clearance and mucosal integrity. However, their relationship with reflux symptoms is not known. We aimed to evaluate the correlations of the PSPW index and esophageal BI with gastroesophageal reflux disease (GERD) symptoms.
Methods
We performed a retrospective review of multichannel intraluminal impedance and pH (MII-pH) tracings in patients with suspected GERD. Reflux symptoms were also analyzed from checklists using ordinal scales. The PSPW index and esophageal BIs in 6 spots (z1-z6) were measured. Bivariate (Pearson) correlation was used to analyze the relationship between the PSPW index or esophageal BI and the degree of GERD symptoms measured.
Results
The MII-pH records of 143 patients were analyzed. The PSPW index was significantly lower in patients who had heartburn and was negatively correlated with the degree of heartburn (r = -0.186, P < 0.05). On the contrary, the PSPW index was not significantly correlated with the degree of dysphagia (r = -0.013, P = 0.874). Distal esophageal BI was not significantly correlated with heartburn, but was negatively correlated with the degree of dysphagia (z3: r = -0.328, z4: r = -0.361, z5: r = -0.316, z6: r = -0.273; P < 0.05).
Conclusions
These findings suggest that delayed chemical clearance 48 of the esophagus may induce heartburn, but that it is not related to dysphagia. However, a lack of esophageal mucosal integrity may be related to dysphagia.
Keywords: Dysphagia; Esophageal baseline impedance; Gastroesophageal reflux; Heartburn; PSPW index


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