{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,22]],"date-time":"2026-04-22T21:30:59Z","timestamp":1776893459723,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T00:00:00Z","timestamp":1603411200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Esophagogastric junction contractile integral (EGJ\u2010CI) and EGJ morphology are high\u2010resolution manometry (HRM) metrics that assess EGJ barrier function. Normative data standardized across world regions and HRM manufacturers are limited.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Our aim was to determine normative EGJ metrics in a large international cohort of healthy volunteers undergoing HRM (Medtronic, Laborie, and Diversatek software) acquired from 16 countries in four world regions. EGJ\u2010CI was calculated by the same two investigators using a distal contractile integral\u2010like measurement across the EGJ for three respiratory cycles and corrected for respiration (mm Hg\u00a0cm), using manufacturer\u2010specific software tools. EGJ morphology was designated according to Chicago Classification v3.0. Median EGJ\u2010CI values were calculated across age, genders, HRM systems, and regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of 484 studies (28.0\u00a0years, 56.2% F, 60.7% Medtronic studies, 26.0% Laborie, and 13.2% Diversatek), EGJ morphology was type 1 in 97.1%. Median EGJ\u2010CI was similar between Medtronic (37.0\u00a0mm Hg\u00a0cm, IQR 23.6\u201053.7\u00a0mm Hg\u00a0cm) and Diversatek (34.9\u00a0mm Hg\u00a0cm, IQR 22.1\u201056.1\u00a0mm Hg\u00a0cm, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.87), but was significantly higher using Laborie equipment (56.5\u00a0mm Hg\u00a0cm, IQR 35.0\u201075.3\u00a0mm Hg\u00a0cm, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). 5<jats:sup>th<\/jats:sup> percentile EGJ\u2010CI values ranged from 6.9 to 12.1\u00a0mm Hg\u00a0cm. EGJ\u2010CI values were consistent across world regions, but different between manufacturers even within the same world region (<jats:italic>P<\/jats:italic>\u00a0\u2264\u00a00.001). Within Medtronic studies, EGJ\u2010CI and basal LESP were similar in younger and older individuals (<jats:italic>P<\/jats:italic>\u00a0\u2265\u00a00.3) but higher in women (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>EGJ morphology is predominantly type 1 in healthy adults. EGJ\u2010CI varies widely in health, with significant gender influence, but is consistent within each HRM system. Manufacturer\u2010specific normative values should be utilized for clinical HRM interpretation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14009","type":"journal-article","created":{"date-parts":[[2020,10,23]],"date-time":"2020-10-23T16:37:20Z","timestamp":1603471040000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Esophagogastric junction morphology and contractile integral on high\u2010resolution manometry in asymptomatic healthy volunteers: An international multicenter study"],"prefix":"10.1111","volume":"33","author":[{"given":"Benjamin D.","family":"Rogers","sequence":"first","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arvind","family":"Rengarajan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Washington University School of Medicine  St Louis MO USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luiz","family":"Abrahao","sequence":"additional","affiliation":[{"name":"University Hospital Clementino Fraga Filho  Rio de Janeiro Brazil"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shobna","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Sir HN Reliance Foundation Hospital  Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5766-9598","authenticated-orcid":false,"given":"Serhat","family":"Bor","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Ege University  Izmir Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Northwestern University  Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0909-5192","authenticated-orcid":false,"given":"Daniel","family":"Cisternas","sequence":"additional","affiliation":[{"name":"Cl\u00ednica Alemana de Santiago Facultad de Medicina Universidad del Desarrollo  Santiago de Chile Chile"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sutep","family":"Gonlachanvit","sequence":"additional","affiliation":[{"name":"Center of Excellence on Neurogastroenterology and Motility Faculty of Medicine Chulalongkorn University  Bangkok Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albis","family":"Hani","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda y Laboratorio de Motilidad Hospital Universitario San Ignacio Pontificia Universidad Javeriana  Bogot\u00e1 Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamal","family":"Hayat","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology St. George\u2019s University Hospitals NHS Trust  London UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Osamu","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Kamimoku SPA Hospital  Minakami Gunma Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6486-7717","authenticated-orcid":false,"given":"Yeung Yeh","family":"Lee","sequence":"additional","affiliation":[{"name":"School of Medical Sciences Universiti Sains Malaysia  Kota Bharu Malaysia"},{"name":"Gut Research Group Faculty of Medicine National University of Malaysia  Kuala Lumpur Malaysia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Maria","family":"Leguizamo","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterolog\u00eda y Laboratorio de Motilidad Hospital Universitario San Ignacio Pontificia Universidad Javeriana  Bogot\u00e1 Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ans","family":"Pauwels","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Catholic University of Leuven  Leuven Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Julio","family":"Perez de la Serna","sequence":"additional","affiliation":[{"name":"Unidad de Motilidad Servicio de Aparto Digestivo Hospital Clinico San Carlos  Madrid Spain"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rosa I.","family":"Ramos","sequence":"additional","affiliation":[{"name":"Motility Lab Department of Gastroenterology British Hospital and El Cruce Hospital  Buenos Aires Argentina"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8478-9659","authenticated-orcid":false,"given":"Jose Maria","family":"Remes\u2010Troche","sequence":"additional","affiliation":[{"name":"Digestive Physiology and Motility Lab Medical Biological Research Institute Universidad Veracruzana  Veracruz M\u00e9xico"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7798-7638","authenticated-orcid":false,"given":"Sabine","family":"Roman","sequence":"additional","affiliation":[{"name":"Digestive Physiology Hospices Civils de Lyon Hopital E Herriot Universit\u00e9 de Lyon  Lyon France"},{"name":"Digestive Physiology Universit\u00e9 de Lyon Lyon I University  Lyon France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edoardo","family":"Savarino","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology Department of Surgery, Oncology and Gastroenterology University of Padua  Padua Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2120-6270","authenticated-orcid":false,"given":"Jordi","family":"Serra","sequence":"additional","affiliation":[{"name":"Motility and Functional Gut Disorders Unit University Hospital Germans Trias I Pujol. 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