The application of Chicago classification 4.0 in esophageal motility disorders of scleroderma: a case-control study in China
Abstract
Systemic sclerosis (SSc) is a rare autoimmune connective tissue disease characterized by multi-organ fibrosis and vasculopathy that frequently involves the esophagus. This study assessed esophageal motility disorders in patients with SSc using High-resolution manometry (HRM) and classified these disorders according to the Chicago Classification version 4.0, aims to investigate the associations between esophageal dysfunction and clinical phenotypes in Chinese SSc patients, while exploring potential modifications to enhance the applicability of the Chicago v4.0 protocol in SSc patients.
We retrospectively identified SSc patients fulfilling 2013 ACR criteria who underwent HRM classified by Chicago v4.0 at our center (2021–2023). Demographics, organ involvement, pulmonary-function tests, echocardiography and reflux symptom scores (RDQ/GERDQ) were extracted from the hospital information system; age and sex matched non-SSc HRM subjects served as controls. Associations between Chicago categories and clinical variables were examined by multinomial logistic regression.
In our study, esophageal motility disorders were present in 76.7% of patients with systemic sclerosis, predominantly characterized by ineffective esophageal motility (IEM) (35%) and absent contractility (AC) (36.67%). The occurrence rate of AC rose with age. Symptoms of gastroesophageal reflux were more common in the AC group [Odds Ratio: 3.23 (1.02-10.22) vs 1.43(0.52-3.95), P<0.05, E value=2.99]. Diffusion capacity…
How strong is the evidence?
Evidence Hub reads this as a case-control. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause.
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