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Abnormalities of Gastric Slow Wave Propagation on Cutaneous High Resolution Electrogastrogram Are Associated with More Severe Clinical Symptoms: 1234

The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S708-S708 [Peer Reviewed Journal]

Copyright Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins Oct 2018 ;ISSN: 0002-9270 ;EISSN: 1572-0241 ;DOI: 10.14309/00000434-201810001-01234

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  • Title:
    Abnormalities of Gastric Slow Wave Propagation on Cutaneous High Resolution Electrogastrogram Are Associated with More Severe Clinical Symptoms: 1234
  • Author: Gharibans, Armen A. ; Coleman, Todd ; Mousa, Hayat ; Kunkel, David
  • Subjects: Questionnaires
  • Is Part Of: The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S708-S708
  • Description: Introduction: Invasive gastric electrical mapping has revealed spatial abnormalities of the slow wave are present among subjects with gastroparesis (GP) (OGrady et al, 2012) and chronic unexplained nausea and vomiting (CUNV) (Angeli et al, 2017). The cutaneous high resolution electrogastrogram (HR- EGG) has been shown to estimate the direction and speed of the gastric slow wave in healthy subjects. In this study, we performed HR-EGG on subjects with active upper gastrointestinal symptoms but negative endoscopy and CT imaging, and evaluated for associations between HR-EGG parameters and symptoms on a validated questionnaire. Methods: HR-EGG was performed on 25 subjects; age: 56±15 years (range 29-80 years); BMI: 26±5 (range 16.4-35.8); 11M/14F; 17±11% gastric retention at 4-hours on scintigraphy (7 subjects below 10%). All subjects completed the PAGI-SYM questionnaire on foregut symptoms, which includes the Gastroparesis Cardinal Symptom Index (GCSI). Volume reconstruction of the torso and stomach from CT images was performed to guide accurate placement of the HR-EGG, which consisted of an array of 25 skin mounted electrodes. The recordings were 30 min fasting and 60 min after consumption of a 250 kCal nutrient bar with 8 ounces of water. Results: The mean overall PAGI-SYM score was 2.1±0.9, with a mean GCSI score of 2.4±0.9. The percentage of normal 2-4 cpm gastric slow waves throughout the recording was 94±6%. The fasting-fed power ratio was 3.2±5.6. Spatial analysis revealed that subjects with a higher percentage of slow waves with abnormal propagation direction, defined as the percentage of slow waves propagating outside the CT-defined axis of the stomach, had a higher GCSI score (r=0.57, p=0.003) (Figure 1). GCSI subtypes with robust correlation included bloating/distension (p=0.01) and fullness/early satiety (p=0.003). No significant correlation (p<0.01) was found between symptoms and traditional EGG parameters. Conclusion: The genesis of symptoms in GP and CUNV is likely multifactorial, including possible pathophysiologic contribution from gastric myoelectric dysfunction. We report here that abnormal spatial parameters on cutaneous HR-EGG correlated robustly with severity of upper gastrointestinal symptoms. This is an important finding as this noninvasive approach can potentially evaluate response to targeted therapies with the ultimate goal of refining the sub-categorization of symptom etiology in patients with GP and CUNV.
  • Publisher: New York: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins
  • Language: English
  • Identifier: ISSN: 0002-9270
    EISSN: 1572-0241
    DOI: 10.14309/00000434-201810001-01234
  • Source: AUTh Library subscriptions: ProQuest Central
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