{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T11:01:08Z","timestamp":1774609268415,"version":"3.50.1"},"reference-count":42,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T00:00:00Z","timestamp":1688688000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2023,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Primary and secondary peristalsis facilitate esophageal bolus transport; however, their relative impact for bolus clearance remains unclear. We aimed to compare primary peristalsis and contractile reserve on high\u2010resolution manometry (HRM) and secondary peristalsis on functional lumen imaging probe (FLIP) Panometry with emptying on timed barium esophagogram (TBE) and incorporate findings into a comprehensive model of esophageal function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Adult patients who completed HRM with multiple rapid swallows (MRS), FLIP, and TBE for esophageal motility evaluation and without abnormal esophagogastric junction outflow\/opening or spasm were included. An abnormal TBE was defined as a 1\u2010min column height &gt;5\u2009cm. Primary peristalsis and contractile reserve after MRS were combined into an <jats:italic>HRM\u2013MRS model<\/jats:italic>. Secondary peristalsis was combined with primary peristalsis assessment to describe a complementary <jats:italic>neuromyogenic model<\/jats:italic>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Key Results<\/jats:title><jats:p>Of 89 included patients, differences in rates of abnormal TBEs were observed with primary peristalsis classification (normal: 14.3%; ineffective esophageal motility: 20.0%; absent peristalsis: 54.5%; <jats:italic>p<\/jats:italic>\u2009=\u20090.009), contractile reserve (present: 12.5%; absent: 29.3%; <jats:italic>p<\/jats:italic>\u2009=\u20090.05), and secondary peristalsis (normal: 9.7%; borderline: 17.6%; impaired\/disordered: 28.6%; absent contractile response: 50%; <jats:italic>p<\/jats:italic>\u2009=\u20090.039). Logistic regression analysis (akaike information criteria, area under the receiver operating curve) demonstrated that the neuromyogenic model (80.8, 0.83) had a stronger relationship predicting abnormal TBE compared to primary peristalsis (81.5, 0.82), contractile reserve (86.8, 0.75), or secondary peristalsis (89.0, 0.78).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Inferences<\/jats:title><jats:p>Primary peristalsis, contractile reserve, and secondary peristalsis were associated with abnormal esophageal retention as measured by TBE. Added benefit was observed when applying comprehensive models to incorporate primary and secondary peristalsis supporting their complementary application.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nmo.14638","type":"journal-article","created":{"date-parts":[[2023,7,7]],"date-time":"2023-07-07T09:52:50Z","timestamp":1688723570000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["The impact of primary peristalsis, contractile reserve, and secondary peristalsis on esophageal clearance measured by timed barium esophagogram"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9346-7085","authenticated-orcid":false,"given":"Andree H.","family":"Koop","sequence":"first","affiliation":[{"name":"Division of Gastroenterology, Department of Medicine Mayo Clinic  Jacksonville Florida 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USA"}],"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, Department of Medicine Northwestern University  Chicago Illinois 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