{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:08:26Z","timestamp":1784308106056,"version":"3.55.0"},"reference-count":29,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"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":[[2025,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>In patients with non\u2010cardiac chest pain (NCCP) and non\u2010obstructive dysphagia (NOD), standard esophageal high resolution manometry (HRM) with water swallows and\/or solid meals may miss intermittent dysmotility. To what extent prolonged 24\u2009h\u2010measurements may increase the diagnostic sensitivity is currently unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>75 patients (47 female, 58\u2009\u00b1\u200916\u2009years) with NCCP and\/or NOD underwent standard HRM (single water swallows plus rice meal) and ambulatory 24\u2010h\u2010HRM with impedance. Results were analyzed according to Chicago Classification v3.0 for water\u2010swallow\u2010HRM; adapted criteria were used for rice\u2010meal and 24\u2010h\u2010HRM. Patients were followed by chart review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>\n                      Contractility parameters obtained by different HRM procedures always correlated (\n                      <jats:italic>R<\/jats:italic>\n                      \u2009&gt;\u20090.27,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). During 24\u2009h\u2010measurements, all parameters showed circadian variability (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In comparison with water\u2010swallow\u2010HRM, rice\u2010meal\u2010HRM markedly increased the proportion of patients diagnosed with achalasia III, esophagogastric outlet obstruction with spastic features, distal esophageal spasm, or hypercontractility (10.7% vs. 21.3%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.039). The diagnostic gain regarding spastic and\/or hypercontractile disorders was further increased by 24\u2010h\u2010HRM (61.3% of patients,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). In 11 out of 21 patients with normal results in both water\u2010swallow\u2010 and rice\u2010meal\u2010HRM (15% of total cohort), 24\u2010h\u2010HRM detected a major motor disorder. Results of 24\u2010h\u2010HRM altered treatment recommendations in 41 patients (54%).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions&amp;Inferences<\/jats:title>\n                    <jats:p>24\u2010h\u2010HRM revealed spastic and\/or hypercontractile esophageal motor disorders in about 60% of patients with NCCP\/NOD and markedly improved diagnostic yield compared with standard HRM, probably partly due to the observed circadian variability of esophageal motility. 24\u2010h\u2010HRM findings frequently altered treatment recommendations, but the ultimate clinical consequences of the increased diagnostic yield have to be examined further.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70048","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T14:33:46Z","timestamp":1744641226000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Additional Diagnostic Yield of Ambulatory 24\u2010h High Resolution Manometry With Impedance in Patients With Non\u2010Cardiac Chest Pain or Non\u2010Obstructive Dysphagia"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5884-1115","authenticated-orcid":false,"given":"Jutta","family":"Keller","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marek","family":"Boedler","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dorothea","family":"Jasper","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viola","family":"Andresen","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ulrich","family":"Rosien","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2270-2495","authenticated-orcid":false,"given":"Thomas","family":"R\u00f6sch","sequence":"additional","affiliation":[{"name":"Department of Interdisciplinary Endoscopy University Hospital Hamburg\u2010Eppendorf  Hamburg Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Layer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Israelitic Hospital Hamburg Academic Hospital University of Hamburg  Hamburg 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