{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T14:27:48Z","timestamp":1769696868401,"version":"3.49.0"},"reference-count":18,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":18,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82500648"],"award-info":[{"award-number":["82500648"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82570626"],"award-info":[{"award-number":["82570626"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002858","name":"China Postdoctoral Science Foundation","doi-asserted-by":"publisher","award":["2024M763808"],"award-info":[{"award-number":["2024M763808"]}],"id":[{"id":"10.13039\/501100002858","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neurogastroenterology Motil"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Clinical non\u2010response to peroral endoscopic myotomy (POEM) is a major clinical challenge of achalasia. Four\u2010dimensional high\u2010resolution impedance manometry (4D\u2010HRIM) enables evaluation of both esophageal motility and bolus clearance. This study investigated whether 4D\u2010HRIM could predict outcomes of POEM in achalasia patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Achalasia patients who underwent preoperative 4D\u2010HRIM evaluation and POEM were retrospectively included. The baseline characteristics, myotomy metrics, traditional preoperative examinations metrics, and 4D\u2010HRIM metrics were compared between clinical response and non\u2010response patients. Statistically significant parameters were selected to deliver receiver operating characteristic curve (ROC) analysis, with stepwise regression constructing optimal prediction models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>A total of 121 achalasia patients were included, of which 10 patients were assigned to the clinical non\u2010response group. While no significant difference was found in HRM, endoscopy, and barium esophagram metrics, patients in the clinical non\u2010response group presented higher phase\u2010specific intrabolus pressure (IBP), increased pressure, and lower distensibility index (DI) of the esophageal body, higher pressure at EGJ, and lower retention ratio under 4D\u2010HRIM evaluation. The area under the curve (AUC) for predicting poor outcomes using a single 4D\u2010HRIM metric, such as phase\u2010specific IBP or DI, ranged from 0.69 to 0.76. The combination of the median IBP at phase 2 and the retention ratio showed the best predictive performance, with an AUC of 0.817.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Inferences<\/jats:title>\n                    <jats:p>4D\u2010HRIM evaluation could help predict clinical outcomes after POEM in achalasia, thereby enabling us to develop personalized surgical strategies and establish more meticulous postoperative follow\u2010up plans.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/nmo.70236","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T15:04:12Z","timestamp":1768835052000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Use of Four\u2010Dimensional Impedance Manometry in Predicting Therapeutic Outcomes of Peroral Endoscopic Myotomy for Achalasia"],"prefix":"10.1111","volume":"38","author":[{"given":"Shimin","family":"Chen","sequence":"first","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Songfeng","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dustin A.","family":"Carlson","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2582-2070","authenticated-orcid":false,"given":"Wenjun","family":"Kou","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dianxuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mengyu","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Niandi","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianjun","family":"Zhuang","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John E.","family":"Pandolfino","sequence":"additional","affiliation":[{"name":"Kenneth C. Griffin Esophageal Center of Northwestern Medicine, Division of Gastroenterology and Hepatology, Department of Medicine, Feinberg School of Medicine Northwestern University  Chicago Illinois USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yinglian","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology The First Affiliated Hospital of Sun Yat\u2010Sen University  Guangzhou Guangdong China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,19]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60651-0"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2021.02.035"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000000955"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1905380"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2024.09.027"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2036.2011.04816.x"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310602"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2017.10.031"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2014-308649"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1055\/a-0658-5783"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2020.06.028"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.gie.2023.10.025"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14803"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820969050"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000003151"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/nmo.14423"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-024-11229-4"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10388-024-01098-0"}],"container-title":["Neurogastroenterology &amp; Motility"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70236","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nmo.70236","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nmo.70236","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T04:13:50Z","timestamp":1769660030000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nmo.70236"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":18,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/nmo.70236"],"URL":"https:\/\/doi.org\/10.1111\/nmo.70236","archive":["Portico"],"relation":{},"ISSN":["1350-1925","1365-2982"],"issn-type":[{"value":"1350-1925","type":"print"},{"value":"1365-2982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]},"assertion":[{"value":"2025-10-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-12-23","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-19","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70236"}}