TY - JOUR
T1 - Gastric alimetry expands patient phenotyping in gastroduodenal disorders compared with gastric emptying scintigraphy
AU - Wang, William Jiaen
AU - Foong, Daphne
AU - Calder, Stefan
AU - Schamberg, Gabriel
AU - Varghese, Chris
AU - Tack, Jan
AU - Xu, William
AU - Daker, Charlotte
AU - Carson, Daniel
AU - Waite, Stephen
AU - Hayes, Thomas
AU - Du, Peng
AU - Abell, Thomas L.
AU - Parkman, Henry P.
AU - Huang, I-Hsuan
AU - Fernandes, Vivian
AU - Andrews, Christopher N.
AU - Gharibans, Armen A.
AU - Ho, Vincent
AU - O'Grady, Greg
N1 - Publisher Copyright:
© 2023 by The American College of Gastroenterology.
PY - 2024/2/1
Y1 - 2024/2/1
N2 - INTRODUCTION: Gastric emptying testing (GET) assesses gastric motility, however, is nonspecific and insensitive for neuromuscular disorders. Gastric Alimetry (GA) is a new medical device combining noninvasive gastric electrophysiological mapping and validated symptom profiling. This study assessed patient-specific phenotyping using GA compared with GET. METHODS: Patients with chronic gastroduodenal symptoms underwent simultaneous GET and GA, comprising a 30-minute baseline, 99mTC-labelled egg meal, and 4-hour postprandial recording. Results were referenced to normative ranges. Symptoms were profiled in the validated GA App and phenotyped using rule-based criteria based on their relationships to the meal and gastric activity: (i) sensorimotor, (ii) continuous, and (iii) other. RESULTS: Seventy-five patients were assessed, 77% female. Motility abnormality detection rates were as follows: GET 22.7% (14 delayed, 3 rapid), GA spectral analysis 33.3% (14 low rhythm stability/low amplitude, 5 high amplitude, and 6 abnormal frequency), and combined yield 42.7%. In patients with normal spectral analysis, GA symptom phenotypes included sensorimotor 17% (where symptoms strongly paired with gastric amplitude, median r 5 0.61), continuous 30%, and other 53%. GA phenotypes showed superior correlations with Gastroparesis Cardinal Symptom Index, Patient Assessment of Upper Gastrointestinal Symptom Severity Index, and anxiety scales, whereas Rome IV Criteria did not correlate with psychometric scores (P > 0.05). Delayed emptying was not predictive of specific GA phenotypes. DISCUSSION: GA improves patient phenotyping in chronic gastroduodenal disorders in the presence and absence of motility abnormalities with increased correlation with symptoms and psychometrics compared with gastric emptying status and Rome IV criteria. These findings have implications for the diagnostic profiling and personalized management of gastroduodenal disorders.
AB - INTRODUCTION: Gastric emptying testing (GET) assesses gastric motility, however, is nonspecific and insensitive for neuromuscular disorders. Gastric Alimetry (GA) is a new medical device combining noninvasive gastric electrophysiological mapping and validated symptom profiling. This study assessed patient-specific phenotyping using GA compared with GET. METHODS: Patients with chronic gastroduodenal symptoms underwent simultaneous GET and GA, comprising a 30-minute baseline, 99mTC-labelled egg meal, and 4-hour postprandial recording. Results were referenced to normative ranges. Symptoms were profiled in the validated GA App and phenotyped using rule-based criteria based on their relationships to the meal and gastric activity: (i) sensorimotor, (ii) continuous, and (iii) other. RESULTS: Seventy-five patients were assessed, 77% female. Motility abnormality detection rates were as follows: GET 22.7% (14 delayed, 3 rapid), GA spectral analysis 33.3% (14 low rhythm stability/low amplitude, 5 high amplitude, and 6 abnormal frequency), and combined yield 42.7%. In patients with normal spectral analysis, GA symptom phenotypes included sensorimotor 17% (where symptoms strongly paired with gastric amplitude, median r 5 0.61), continuous 30%, and other 53%. GA phenotypes showed superior correlations with Gastroparesis Cardinal Symptom Index, Patient Assessment of Upper Gastrointestinal Symptom Severity Index, and anxiety scales, whereas Rome IV Criteria did not correlate with psychometric scores (P > 0.05). Delayed emptying was not predictive of specific GA phenotypes. DISCUSSION: GA improves patient phenotyping in chronic gastroduodenal disorders in the presence and absence of motility abnormalities with increased correlation with symptoms and psychometrics compared with gastric emptying status and Rome IV criteria. These findings have implications for the diagnostic profiling and personalized management of gastroduodenal disorders.
KW - chronic nausea and vomiting syndromes
KW - functional dyspepsia
KW - gastroparesis
KW - motility disorders
KW - disorders of gut-brain interaction
UR - https://hdl.handle.net/1959.7/uws:74970
UR - http://www.scopus.com/inward/record.url?scp=85184281461&partnerID=8YFLogxK
U2 - 10.14309/ajg.0000000000002528
DO - 10.14309/ajg.0000000000002528
M3 - Article
VL - 119
SP - 331
EP - 341
JO - The American Journal of Gastroenterology
JF - The American Journal of Gastroenterology
IS - 2
ER -