{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:31:42Z","timestamp":1793349102394,"version":"4.5.0"},"reference-count":18,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T00:00:00Z","timestamp":1759968000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["R01 DK137775"],"award-info":[{"award-number":["R01 DK137775"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2025,12]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background and Aims<\/jats:title>\n \n Achalasia subtypes are classified by high\u2010resolution manometry (\n HRM<\/jats:styled-content>\n ) based on esophageal pressurization and contractility patterns, while esophagram\u2010based classifications emphasize esophageal anatomy. We aimed to evaluate the relationship between esophageal pressurization on\n HRM<\/jats:styled-content>\n and esophageal anatomy on esophagram among patients with untreated achalasia.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Adult patients with treatment\u2010na\u00efve achalasia that completed\n HRM<\/jats:styled-content>\n and esophagram were included.\n HRM<\/jats:styled-content>\n achalasia subtypes were determined by the Chicago Classification with pan\u2010esophageal pressurization (\n PEP<\/jats:styled-content>\n ) measured among type I and type\n II<\/jats:styled-content>\n achalasia. Anatomy on esophagram was assessed using the Brazilian (esophageal width) and Japanese Esophageal Society (\n JES<\/jats:styled-content>\n ; angulation\/tortuosity) classifications.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n 222 patients, mean (\n SD<\/jats:styled-content>\n ) age 56 (16), 49% female were included. On\n HRM<\/jats:styled-content>\n , 32% were type I, 53% were type\n II<\/jats:styled-content>\n , and 15% were type\n III<\/jats:styled-content>\n achalasia. Esophageal width and\n JES<\/jats:styled-content>\n classification differed by\n HRM<\/jats:styled-content>\n subtype (\n p<\/jats:italic>\n \u2010values <\u20090.001) with type I (\n HRM<\/jats:styled-content>\n ) having greatest esophageal width (median (\n IQR<\/jats:styled-content>\n ) 5.1(4.0\u20136.0) cm) and most\n JES<\/jats:styled-content>\n \u2010C 93% (14\/15), while type\n III<\/jats:styled-content>\n achalasia had the least (width 2.6 (2.0\u20133.0) cm) and 0 were\n JES<\/jats:styled-content>\n \u2010C. Among type I and\n II<\/jats:styled-content>\n achalasia, higher esophageal width was significantly correlated with lower median\n PEP<\/jats:styled-content>\n and fewer swallows exceeding\n PEP<\/jats:styled-content>\n thresholds of 10, 15, 20, or 30\u2009\n mmHg<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n HRM<\/jats:styled-content>\n subtypes and\n PEP<\/jats:styled-content>\n on\n HRM<\/jats:styled-content>\n correlated with esophageal morphology defined on esophagram. However, imperfect concordance between\n HRM<\/jats:styled-content>\n and esophagram classifications suggests complementary value to assess achalasia disease stages related to disease chronicity and esophageal wall mechanics. Future investigations to facilitate combined assessment with\n HRM<\/jats:styled-content>\n and esophagram may enhance achalasia phenotyping and treatment planning.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/nmo.70180","type":"journal-article","created":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T04:14:45Z","timestamp":1760069685000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Functional\u2010Structural Correlates in Achalasia: The Relationship of Esophageal Pressurization and Anatomy"],"prefix":"10.1111","volume":"37","author":[{"given":"John E.","family":"Pandolfino","sequence":"first","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Goudie","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"},{"name":"Division of Thoracic Surgery, Department of Surgery Universit\u00e9 de Montr\u00e9al Montreal Quebec Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob M.","family":"Schauer","sequence":"additional","affiliation":[{"name":"Division of Biostatistics, Department of Preventive Medicine, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico A.","family":"Farina","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leya","family":"Chambo","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Ravich","sequence":"additional","affiliation":[{"name":"Section of Digestive Diseases, Department of Internal Medicine Yale University School of Medicine New Haven Connecticut USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Kelahan","sequence":"additional","affiliation":[{"name":"Department of Radiology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1702-7758","authenticated-orcid":false,"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, Feinberg School of Medicine Northwestern University Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,9]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.07.022"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2982.2011.01834.x"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.12477"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14058"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010018\u20103956\u2010x"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14785"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000137"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388\u2010017\u20100589\u20101"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010014\u20102940\u20101"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14552"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.2214\/ajr.169.2.9242756"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605\u2010010\u20101318\u20104"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.5056\/jnm.2011.17.1.48"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.12.027"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2019.10.008"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.085423"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2018.04.033"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2015.08.005"}],"container-title":["Neurogastroenterology & Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70180","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70180","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70180","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T07:50:53Z","timestamp":1793346653000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70180"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,9]]},"references-count":18,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,12]]}},"alternative-id":["10.1111\/nmo.70180"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70180","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,9]]},"assertion":[{"value":"2025-08-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-09-29","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-09","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70180"}}