{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:17:26Z","timestamp":1777655846535,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2018,10,1]],"date-time":"2018-10-01T00:00:00Z","timestamp":1538352000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100009396","name":"Universit\u00e4tsSpital Z\u00fcrich","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100009396","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2019,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>This study assessed whether high\u2010resolution manometry (<jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content>) with a test meal can detect clinically relevant, abnormal motility already in very early systemic sclerosis (<jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c) and whether this finding is associated with subsequent disease progression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective, longitudinal cohort study recruited 68 consecutive <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c patients (group #1: 32 established disease (<jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>, American College of Rheumatology \/<jats:styled-content style=\"fixed-case\">EULAR<\/jats:styled-content>, The European League against Rheumatism 2013 and <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content> 1980 criteria fulfilled); group #2: 24 early disease (only <jats:styled-content style=\"fixed-case\">ACR<\/jats:styled-content>\/<jats:styled-content style=\"fixed-case\">EULAR<\/jats:styled-content> 2013 fulfilled); group #3: 12 very early disease (clinical expert diagnosis of <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c) and 72 healthy controls. <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> evaluated esophageal motility for water swallows and a solid test meal.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Systemic sclerosis patients had less frequent effective esophageal contractions during the test meal compared to healthy controls even in very early disease (0.15, 1.0, 2.1 per minute for groups #1, #2, and #3, vs 2.5 per minute in health; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, and <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0085, respectively). Ineffective motility at <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> was associated with a higher modified Rodnan skin score at baseline. Moreover, at mean 18 (10\u201031) months of follow\u2010up, the presence of ineffective motility at baseline was associated with progression of skin disease (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.01). Cox proportional hazard regression analysis identified hypotensive peristalsis in the test meal (&lt;15% effective solid swallows) and low distal contractile integral (DCI; &lt;400 mm Hg\u00b7cm\u00b7s) as predictors for skin aggravation, but not for new organ involvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ineffective motility during a test meal is present already in patients with very early <jats:styled-content style=\"fixed-case\">SS<\/jats:styled-content>c. Findings on <jats:styled-content style=\"fixed-case\">HRM<\/jats:styled-content> studies are associated with disease severity at baseline, and low percentage of effective swallows in test meal and low mean DCI are both predictors of skin progression during follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.13480","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T06:29:13Z","timestamp":1538461753000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Abnormal esophageal motility during a solid test meal in systemic sclerosis\u2014detection even in very early disease and association with disease progression"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9759-122X","authenticated-orcid":false,"given":"Simon","family":"B\u00fctikofer","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology University 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