{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:42:58Z","timestamp":1792395778910,"version":"4.4.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T00:00:00Z","timestamp":1646265600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Impedance\u2010pH monitoring allows evaluation of esophageal chemical clearance, a response to reflux elicited by the esophago\u2010salivary reflex, by means of the post\u2010reflux swallow\u2010induced peristaltic wave (PSPW) index; mucosal integrity can be evaluated by means of mean nocturnal baseline impedance (MNBI) and is regarded as a GERD marker. Currently, the relationship between PSPW index and MNBI has not yet been fully investigated and represents the aim of the present study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Impedance\u2010pH tracings from consecutive patients were reviewed. ROC analysis and multivariate regression models were generated to evaluate the association between acid exposure time (AET), total refluxes (TRs), PSPW index, and MNBI. Patients were classified by means of AET thresholds and symptom\u2010reflux association indexes into conclusive and inconclusive GERD, reflux hypersensitivity (RH), and functional heartburn (FH). Pathologic MNBI &lt;2292 \u2126 was defined according to published outcome studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Two hundred and thirty patients constituted the study cohort. Overall, a significant direct correlation was observed between PSPW index and MNBI (0.759,\n                      <jats:italic>p\u00a0<\/jats:italic>\n                      &lt;\u00a00.001). At ROC analysis, a PSPW index cut\u2010off value of 53% was the best discriminator between normal from pathologic MNBI values (sensitivity 88%, specificity 86.4%). Considering AET cut\u2010off of 4% or 6%, a sensitivity of 80.7% and 46% and a specificity of 62.5% and 93.2% were found, respectively. According to multivariate analysis, AET &gt;4% and PSPW index value &lt;53% or &lt;61% were significantly associated with pathologic MNBI values.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Inferences<\/jats:title>\n                    <jats:p>Esophageal chemical clearance is a major defense mechanism against reflux and its impairment represents a major determinant of reflux\u2010associated mucosal damage.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.14344","type":"journal-article","created":{"date-parts":[[2022,3,3]],"date-time":"2022-03-03T06:43:19Z","timestamp":1646289799000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Association between post\u2010reflux swallow\u2010induced peristaltic wave index and esophageal mucosal integrity in patients with GERD symptoms"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5102-1758","authenticated-orcid":false,"given":"Mentore","family":"Ribolsi","sequence":"first","affiliation":[{"name":"Department of Digestive Diseases Campus Bio Medico University of Rome  Roma Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8608-1563","authenticated-orcid":false,"given":"Marzio","family":"Frazzoni","sequence":"additional","affiliation":[{"name":"Digestive Pathophysiology Unit Azienda Ospedaliero\u2010Universitaria di Modena Ospedale Civile di Baggiovara  Modena Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Cicala","sequence":"additional","affiliation":[{"name":"Department of Digestive Diseases Campus Bio Medico University of Rome  Roma 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