RESEARCH - A new method for evaluation of intestinal muscle contraction properties in systemic sclerosis

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Neurogastroenterol Motil. 2007 Jan;19(1):11-9.

A new method for evaluation of intestinal muscle contraction properties:

studies in normal subjects and in patients with systemic sclerosis.

Center of Excellence in Visceral Biomechanics and Pain, Aalborg Hospital,

Aalborg, Denmark.

Systemic sclerosis is a connective tissue disease that involves the

gastrointestinal (GI) tract. Seventy-five per cent of systemic sclerosis

patients experience symptoms arising from oesophagus. The intestine has less

frequently been subject for studies than the oesophagus. When the small

intestine becomes involved, nausea, vomiting, bloating, diarrhoea and

malabsorption may occur. Previous studies have shown decreased and abnormal

intestinal motility, dilatation and a stiffer wall. The aim was to study

muscle mechanics in systemic sclerosis patients using novel analysis of

intestinal muscle contraction force-velocity and power. A volume-controlled

duodenal ramp-distension protocol was used in nine patients and eight

healthy controls. The wall stretch ratio, tension, shortening velocity and

muscle power were computed from pressure and cross-sectional area data

recorded by an impedance planimetry system. The tension-stretch ratio

relation obtained in patients was shifted to the left, indicating a stiffer

wall. The in vivo tension-shortening velocity relationship was quantified

using Hill's equation. The maximum preload tension (tension at zero

velocity) was lower in the patients than in the healthy controls (P <

0.001). The muscle power was lowest in the patients. An association was

found between the duration of the disease and the maximum stretch ratio (P <

0.05). The study represents the first data with application of in vivo

muscle force-velocity relations in patients with gastrointestinal diseases.

Systemic sclerosis patients had increased stiffness and impaired muscle

dynamics of the duodenum. Decreased muscle function and increased wall

stiffness may explain the GI symptoms reported in this patient group.

PMID: 17187584

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