{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T16:54:06Z","timestamp":1791219246699,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T00:00:00Z","timestamp":1635379200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["P01 DK117824"],"award-info":[{"award-number":["P01 DK117824"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["R01 AR073270"],"award-info":[{"award-number":["R01 AR073270"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Although esophageal dysmotility is common in systemic sclerosis (SSc)\/scleroderma, little is known regarding the pathophysiology of motor abnormalities driving reflux severity and dysphagia. This study aimed to assess primary and secondary peristalsis in SSc using a comprehensive esophageal motility assessment applying high\u2010resolution manometry (HRM) and functional luminal imaging probe (FLIP) Panometry.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 32 patients with scleroderma (28 female; ages 38\u201377; 20\u00a0limited SSc, 12 diffuse SSc) completed FLIP Panometry and HRM. Secondary peristalsis, i.e., contractile responses (CR), was classified on FLIP Panometry by pattern of contractility as normal (NCR), borderline (BCR), impaired\/disordered (IDCR), or absent (ACR). Primary peristalsis on HRM was assessed according to the Chicago classification.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The manometric diagnoses were 56% (<jats:italic>n<\/jats:italic>\u00a0=\u00a018) absent contractility, 22% (<jats:italic>n<\/jats:italic>\u00a0=\u00a07) ineffective esophageal motility (IEM), and 22% (<jats:italic>n<\/jats:italic>\u00a0=\u00a07) normal motility. Secondary peristalsis (CRs) included 38% (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) ACR, 38% (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) IDCR, 19% (<jats:italic>n\u00a0=<\/jats:italic>\u00a06) BCR, and 15% (<jats:italic>n\u00a0=<\/jats:italic>\u00a05) NCR. The median (IQR) esophagogastric junction (EGJ) distensibility index (DI) was 5.8\u00a0mm<jats:sup>2<\/jats:sup>\/mmHg (4.8\u201310.1) mm<jats:sup>2<\/jats:sup>\/mmHg; EGJ\u2010DI was &gt;8.0\u00a0mm<jats:sup>2<\/jats:sup>\/mmHg in 31%, and &gt;2.0\u00a0mm<jats:sup>2<\/jats:sup>\/mmHg in 100% of patients. Among 18 patients with absent contractility on HRM, 11\u00a0had ACR, 5\u00a0had IDCR, and 2\u00a0had BCR. Among 7 patients with IEM, 1\u00a0had ACR, 5\u00a0had IDCR, and 1\u00a0NCR. All of the patients with normal peristalsis had NCR or BCR.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>This was the first study assessing combined HRM and FLIP Panometry in a cohort of SSc patients, which demonstrated heterogeneity in primary and secondary peristalsis. This complementary approach facilitates characterizing esophageal function in SSc, although future study to examine clinical outcomes remains necessary.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14284","type":"journal-article","created":{"date-parts":[[2021,10,28]],"date-time":"2021-10-28T15:12:01Z","timestamp":1635433921000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Heterogeneity of primary and secondary peristalsis in systemic sclerosis: A new model of \u201cscleroderma esophagus\u201d"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacqueline E.","family":"Prescott","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Germond","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Darren","family":"Brenner","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Carns","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chase S.","family":"Correia","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie\u2010Pier","family":"Tetreault","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology Department of Medicine Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsanna H.","family":"McMahan","sequence":"additional","affiliation":[{"name":"Division of Rheumatology Department of Medicine Johns Hopkins School of Medicine  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monique","family":"Hinchcliff","sequence":"additional","affiliation":[{"name":"Division of 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