Distinct Subgroups in Gastroparesis Defined by Simultaneous Body Surface Gastric Mapping and Gastric Emptying Breath Testing.

IF 2.9 3区医学 Q1 CLINICAL NEUROLOGY

Neurogastroenterology and Motility Pub Date : 2025-07-28 DOI:10.1111/nmo.70124

Chris Varghese, I-Hsuan Huang, Gabriel Schamberg, Stefan Calder, Christopher N Andrews, Greg O'Grady, Jan Tack, Armen A Gharibans

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引用次数: 0

Abstract

Background: Gastroparesis is a heterogeneous disorder with several contributing pathophysiologies. In this study, we used simultaneous body surface gastric mapping (BSGM) and gastric emptying breath testing (GEBT) to subgroup patients with gastroparesis based on dynamic spectral meal response profiles and emptying rate.

Methods: Patients with chronic gastroduodenal symptoms and negative gastroscopy underwent simultaneous BSGM and GEBT with 30 min fasting and 4 h postprandial recording. In addition to standard metrics, the BSGM 'meal response ratio' (MRR) compared amplitude in the first 2 h postprandially to the subsequent 2 h (lagged meal response ≤ 1).

Results: One hundred and forty-three patients underwent simultaneous BSGM and GEBT (79% female, median age 31 years, median BMI 23 kg/m²), of whom 36 of 143 (25.2%) had delayed gastric emptying. Those with a lagged meal response had longer T_1/2 (median 95.0 [IQR 59-373] vs. median 78.0 [IQR 31-288], p = 0.009) and higher rates of delayed emptying (42.9% vs. 16.7% p = 0.03). BSGM phenotypes identified in patients with delayed emptying were lagged meal response (25%), low gastric amplitude/rhythm stability (30.6%), elevated gastric frequencies (11.1%), and normal BSGM spectral analysis (33.3%). T_1/2 weakly correlated with worse total symptom burden score (r = 0.18, p = 0.03).

Conclusion: Combined BSGM and gastric emptying testing defines subgroups of gastroparesis based on several BSGM abnormalities, including a novel group with delayed postprandial onset of gastric motor activity in association with delayed emptying.

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胃轻瘫的不同亚群由同时体表胃测绘和胃排空呼吸试验确定。

背景：胃轻瘫是一种具有多种病理生理机制的异质性疾病。在这项研究中，我们同时使用体表胃测图（BSGM）和胃排空呼吸测试（GEBT），根据动态光谱进食反应谱和排空率对胃轻瘫患者进行亚组。方法：慢性胃十二指肠症状和胃镜检查阴性的患者同时进行BSGM和GEBT，禁食30 min，餐后4 h记录。除了标准指标外，BSGM的“进食反应比”（MRR）比较餐后前2小时与随后2小时的振幅（滞后进食反应≤1）。结果：143例患者同时行BSGM和GEBT(79%为女性，中位年龄31岁，中位BMI为23 kg/m2)，其中36例（25.2%）胃排空延迟。进餐反应滞后的患者有较长的T1/2（中位数为95.0 [IQR 59-373]对中位数为78.0 [IQR 31-288], p = 0.009）和较高的排空延迟率（42.9%对16.7% p = 0.03）。排空延迟患者的BSGM表型包括进餐反应滞后（25%）、胃振幅/节奏稳定性低（30.6%）、胃频率升高（11.1%）和BSGM谱分析正常（33.3%）。T1/2与总症状负担评分较差呈弱相关（r = 0.18, p = 0.03）。结论：BSGM和胃排空联合试验根据几种BSGM异常定义了胃轻瘫的亚组，包括一个与胃排空延迟相关的餐后胃运动活动延迟的新组。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Neurogastroenterology and Motility 医学-临床神经学

CiteScore

7.80

自引率

8.60%

发文量

178

审稿时长

3-6 weeks

期刊介绍： Neurogastroenterology & Motility (NMO) is the official Journal of the European Society of Neurogastroenterology & Motility (ESNM) and the American Neurogastroenterology and Motility Society (ANMS). It is edited by James Galligan, Albert Bredenoord, and Stephen Vanner. The editorial and peer review process is independent of the societies affiliated to the journal and publisher: Neither the ANMS, the ESNM or the Publisher have editorial decision-making power. Whenever these are relevant to the content being considered or published, the editors, journal management committee and editorial board declare their interests and affiliations.