The prevalence and significance of increased gastric wall radiotracer uptake in sestamibi myocardial perfusion SPECT

Background: Limited available data indicate that a specific pattern of increased gastric wall radiotracer uptake is associated with dyspepsia. Our purpose was to evaluate the frequency of this finding and its relation with dyspeptic evidences. Method: 1056 consecutive outpatients referred for myocardial perfusion SPECT were interviewed concerning the dyspeptic symptoms, current gastric medications and previous gastroduodenal interventions. The intensity of gastric wall activity was graded qualitatively as G1 or hyperactive gastric wall (equivalent to the patient’s heart activity) and G2 (less than heart activity). Results: The pattern of gastric wall hyperactivity was identified in 1.9% of patients. Dyspeptic symptoms were present in 80 and 18.6% of G1 and G2 patients, respectively (p<0.001). The dyspeptic symptoms were classified as ulcer-like in 37.5%, dysmotility-like in 43.75% and GERD-like in 18.75% of the dyspeptic G1 patients. Considering the classification of dyspepsia, there was no significant difference between the dyspeptic patients of groups. The history of previous gastroduodenal interventions and current use of gastric medications was significantly higher among G1 patients. Conclusion: The infrequent pattern of gastric wall hyperactivity could be clinically important and can identify a category of patients, who require additional diagnostic gastrointestinal investigation to specify another possible noncardiac origin of complaints.