Oesophageal motility patterns and arterial blood pressure in patients withchest pain and normal coronary angiogram

Background and objectives In previous manometric investigations, we observe d that patients with chest pain and arterial hypertension frequently tend t o display oesophageal motility abnormalities. Therefore, we set out to stud y this systematically. Methods Patients with chest pain and normal coronary angiogram (n = 40) and healthy controls (n = 20) were studied prospectively in a standardized fas hion using a portable oesophageal manometry and blood pressure registration system over 24 hours. Results Twenty patients exhibited increased arterial blood pressure (24 h m edian > 135/85 mmHg), while in the other 20 patients and all controls the 2 4 h blood pressure patterns were normal. Median pressure amplitudes in the distal oesophagus were 46.5, 33 and 27 mmHg in patients with or without art erial hypertension and controls, respectively, and 30, 27 and 27 mmHg in th e proximal oesophagus, respectively. The durations of distal contractions w ere 3.9, 3.4 and 3.4 s, respectively, and those of proximal contractions we re 3.2, 3.0 and 3.2 s, respectively. Percentages of propulsive contractions were 53%, 44% and 59%, respectively, and those of simultaneous contraction s were 23%, 25% and 10%, respectively. Conclusions Patients and controls differ significantly regarding their oeso phageal motility patterns. Patients without arterial hypertension exhibit i mpaired propulsion of oesophageal contractions, whereas patients with arter ial hypertension tend to produce oesophageal hypermotility, This suggests t hat, depending on the presence or absence of arterial hypertension, differe nt pathomechanisms of oesophageal motility disturbances come into play. Eur J Gastroenterol Hepatol 10:941-945 (C) 1998 Lippincott Williams & Wilkins.