Exertional esophageal pH-metry and manometry in recurrent chest pain

Table 1 Demographic and clinical data of investigated patients with a comparison of subjects without and with significant (> 50%) coronary artery narrowing n (%)

Parameter	Significant coronary artery narrowing
	No (n = 65)	Yes (n = 46)
Males/females	29/36 (45/55)	31/15 (67/33)
Age (yr)	55.0 ± 8.8	55.0 ± 8.8
BMI (kg/m2)	28.7 ± 4.2	27.8 ± 3.9
WHR	0.94 ± 0.9	0.93 ± 0.07
Smoking	11 (17)	10 (21)
History of PCI	0	21 (46)a
History of CABG	0	9 (19)a
History of myocardial infarction	0	18 (40)
Hypertension	24 (39)	24 (52)
Systolic blood pressure (mmHg)	122.8 ± 17.7	123.4 ± 17.4
Diastolic blood pressure (mmHg)	82.0 ± 11.2	81.1 ± 9.3
Diabetes mellitus	4 (5)	7 (13)
Total cholesterol (mg/dL)	195.7 ± 28.1	218.9 ± 48.3a
LDL cholesterol (mg/dL)	122.7 ± 25.9	136.1 ± 39.6
HDL cholesterol (mg/dL)	52.1 ± 11.9	48.5 ± 12.9
Triglycerides (mg/dL)	100.1 ± 33.0	166.1 ± 84.5a
Blood glucose (mg/dL)	100.2 ± 15.8	95.0 ± 17.7
Stress test duration (s)	455 ± 172	549 ± 191a
ST interval depression > 1 mm without chest pain during treadmill (silent ischemia)	28 (43)	17 (37)
Chest pain without ST interval depression during stress test	9 (14)	4 (9)
GER-related chest pain	7 (11)	4 (9)
Non-GER-related chest pain	35 (54)	22 (48)
Erosive esophagitis in endoscopy	16 (25)	17 (37)
Pathological GER	19 (29)	16 (35)
DES	13 (20)	10 (22)
epGER	12 (18)	4 (9)
epDES	14 (22)	9 (20)

Data presented as n (%) or mean ± SD.

^aP < 0.05 in an unpaired Student t-test or Fisher exact test. BMI: Body mass index; WHR: Waist/hip ratio; LDL: Low density lipoprotein; HDL: High density lipoprotein; PCI: Percutaneous coronary intervention; CABG: Coronary artery bypass graft; GER: Gastroesophageal reflux (> 4.5% time of esophageal monitoring with pH < 4); DES: Diffuse esophageal spasm, defined as esophageal motility abnormality with more than 30% of simultaneous contractions; epGER; Exercise-provoked GER, defined as a decrease in esophageal pH during a stress test for more than 10 s.

Table 2 Parameters for the clinical usefulness of exercise-provoked chest pain, exercise-provoked gastroesophageal reflux, and exercise-provoked esophageal spasm in the diagnosis of gastroesophageal reflux-related and non-gastroesophageal reflux-related spontaneous chest pain based on 24-h esophageal function examination (n = 111) (%)

Parameter	epCPforboth sCP	epCP for GER-related sCP	epCP for non-GER-related sCP	epGER for GER-related sCP	EPES for non-GER-related sCP
Accuracy	28	42	57	44	48
Sensitivity	35	0	36	36	23
Specificity	80	83	83	92	84
PPV	64	0	64	44	59
NPV	55	89	61	89	53
LR+	1.75	0	2.1	4.5	1.4
LR-	0.81	1.2	0.77	0.7	0.92

epCP: Exercise-provoked chest pain; sCP: Spontaneous chest pain; EPES: Exercise-provoked esophageal spasm; GER: Gastroesophageal reflux; PPV: Positive predictive value; NPV: Negative predictive value; LR+: Positive likelihood ratio; LR-: Negative likelihood ratio.