Computer-aided analysis of human esophageal peristalsis: I. Technical description and comparison with manual analysis

Manual and computer analysis of esophageal peristaltic activity induced by swallows of 5ml water were compared in 6 healthy subjects under basal conditions and following i.v. injection of 4 pharmacological agents: edrophonium (E, 0.08mg/kg), atropine (A, 0.6mg), pentagastrin (PG, 0.6mcg/kg), and glucagon (GL, lmcg). Esophageal manometry was performed using a low compliance perfusion system and recorded on paper for standard manual analysis. The signal was concurrently taped on an analog recorder for subsequent digitization and analysis on a PDP-11 computer using a locally developed program. With both methods we determined the wave amplitude, duration, average upward slope (dP/dT), and velocity of wave progression. In addition, the computer allowed calculation of area under each wave and maximum upward slope (Max dP/dT). We found no significant difference between results of the parameters measured using both methods. Wave amplitude was significantly increased by E and significantly decreased by A. Average upward slope was decreased and velocity was significantly increased only by A. Computer-calculated wave area and Max dP/dT were significantly changed by both E and A. PG and GL had no effect on any of the measured parameters of the peristaltic wave. Esophageal peristalsis can be analyzed using a computer-aided method, providing a rapid and objective measurement of classical parameters and access to more in-depth analysis.