S975 Ineffective Esophageal Motility and Lung Function Decline in Non-Connective Tissue Disease Interstitial Lung Disease: A Retrospective Cohort Analysis

Introduction: Esophageal dysmotility has been implicated in the development of microaspiration in patients with Interstitial lung disease (ILD). Although esophageal dysmotility has been studied in patients with connective tissue disorders, there is a paucity of data evaluating it in ILD patients without connective tissue disorders. This study aims to evaluate the impact of esophageal dysmotility in patients with ILD without connective tissue disorders on pulmonary outcomes. Methods: This is a retrospective study of adult patients at a single academic institution diagnosed with non-connective tissue disease (non-CTD) ILD who underwent esophageal manometry testing between January 1, 2015, and May 30, 2024. Patients with achalasia, nutcracker esophagus, and CTD were excluded. Data from the electronic medical record included demographic information, pulmonary function test (PFT) results, esophageal pH testing results, and esophageal manometry information. Mann-Whitney U testing was used to compare numerical variables with a P-value < 0.05 being considered significant. Results: Of 57 patients included, 21 (36.8%) were found to have ineffective esophageal motility (IEM). Compared to non-IEM patients, those with IEM demonstrated significantly greater total decline in diffusing capacity for carbon monoxide (24.86% vs 12.10%; P < 0.03). Total forced vital capacity decline was non-significantly higher in the IEM group compared that to non-IEM group (14.63% vs 11.94%; P = 0.18). The IEM group also demonstrated significantly higher mean striated esophageal contractile integral than the non-IEM group (270.78 mmHg vs 154.65 mmHg; P-value = 0.024). Lower esophageal sphincter (LES) pressure mean was lower in IEM patients (18.73 vs 22.76 mmHg; P = 0.079), while other esophageal parameters including upper esophageal sphincter pressure, LES integrated relaxation pressure, and esophagogastric junction contractile integral showed no significant differences. However, mortality rates were comparable between groups (29.3% vs 30.0%; P = 0.943). Conclusion: Ineffective esophageal motility is more prevalent in ILD patients without CTD than once realized. Presence of poor esophageal function in this population might have potential implication on worse pulmonary outcomes.