{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T12:47:11Z","timestamp":1785242831848,"version":"3.55.0"},"reference-count":35,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T00:00:00Z","timestamp":1495670400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2017,11]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>Acid exposure time (AET<\/jats:styled-content>) is considered the most useful parameter to predict response of reflux\u2010related heartburn to medical or surgical treatment. However, recent studies showed high rates of heartburn response to proton pump inhibitor (PPI<\/jats:styled-content>) therapy in patients with normal AET<\/jats:styled-content>.<\/jats:p>We aimed to compare the efficacy of postreflux swallow\u2010induced peristaltic wave (PSPW<\/jats:styled-content>) index and mean nocturnal baseline impedance (MNBI<\/jats:styled-content>) with AET<\/jats:styled-content> in linking PPI<\/jats:styled-content>\u2010responsive heartburn to reflux.<\/jats:p><\/jats:sec>Methods<\/jats:title>Off\u2010therapy impedance\u2010pH<\/jats:styled-content> tracings from 425 patients, 317 with PPI<\/jats:styled-content>\u2010responsive and 108 with PPI<\/jats:styled-content>\u2010refractory heartburn were blindly re\u2010analyzed. Demographic and endoscopic characteristics, conventional impedance\u2010pH<\/jats:styled-content> variables, PSPW<\/jats:styled-content> index, and MNBI<\/jats:styled-content> were assessed with multivariate logistic regression to identify factors independently associated with PPI<\/jats:styled-content> responsiveness. Prediction models were developed to assess the strength of reflux linkage with factors independently associated with PPI<\/jats:styled-content> responsiveness by calculating the area under the curve (AUC<\/jats:styled-content>) at receiver\u2010operating\u2010characteristic (ROC<\/jats:styled-content>) analysis.<\/jats:p><\/jats:sec>Key Results<\/jats:title>At multivariate logistic regression analysis, AET<\/jats:styled-content>, MNBI<\/jats:styled-content>, and PSPW<\/jats:styled-content> index were the only factors independently associated with PPI<\/jats:styled-content> responsiveness, abnormal values found in 60%, 76%, and 92% of PPI<\/jats:styled-content>\u2010responsive cases (P<\/jats:italic><.017). At ROC<\/jats:styled-content> analysis, PSPW<\/jats:styled-content> index (AUC<\/jats:styled-content>:.794, P<\/jats:italic>=.002) and MNBI<\/jats:styled-content> (AUC<\/jats:styled-content>: 0.742, P<\/jats:italic>=.003), both separately and combined (AUC<\/jats:styled-content>: 0.811, P<\/jats:italic><.001) linked reflux with PPI<\/jats:styled-content>\u2010responsiveness better than AET<\/jats:styled-content> (AUC<\/jats:styled-content>: 0.687).<\/jats:p><\/jats:sec>Conclusions & Inferences<\/jats:title>AET<\/jats:styled-content>, PSPW<\/jats:styled-content> index, and MNBI<\/jats:styled-content> are independently associated with PPI<\/jats:styled-content>\u2010responsive heartburn. PSPW<\/jats:styled-content> index and MNBI<\/jats:styled-content> can link PPI<\/jats:styled-content>\u2010responsive heartburn to reflux better than AET<\/jats:styled-content> and should become part of the standard analysis of impedance\u2010pH<\/jats:styled-content> tracings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13116","type":"journal-article","created":{"date-parts":[[2017,5,25]],"date-time":"2017-05-25T17:21:33Z","timestamp":1495732893000},"source":"Crossref","is-referenced-by-count":127,"title":["Postreflux swallow\u2010induced peristaltic wave index and nocturnal baseline impedance can link PPI<\/scp>\u2010responsive heartburn to reflux better than acid exposure time"],"prefix":"10.1111","volume":"29","author":[{"given":"L.","family":"Frazzoni","sequence":"first","affiliation":[{"name":"Digestive Pathophysiology Unit and Digestive Endoscopy Unit Baggiovara Hospital Modena Italy"},{"name":"Department of Medical and Surgical Sciences University of Bologna Bologna 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