J Neurogastroenterol Motil.  2019 Apr;25(2):276-285. 10.5056/jnm18192.

High-resolution Mapping of Hyperglycemia-induced Gastric Slow Wave Dysrhythmias

• Du P
• O'Grady G
• Paskaranandavadivel N
• Tang SJ
• Abell T
• Cheng LK

• KMID: 2449100
• DOI: http://doi.org/10.5056/jnm18192

Abstract

BACKGROUND/AIMS
It is now recognised that gastric dysrhythmias are best characterised by their spatial propagation pattern. Hyperglycemia is an important cause of gastric slow wave dysrhythmia, however, the spatiotemporal patterns of dysrhythmias in this context have not been investigated. This study aims to investigate the relationship between hyperglycemia and the patterns of dysrhythmias by employing high-resolution (multi-electrode) mapping simultaneously at the anterior and posterior gastric serosa.
METHODS
High-resolution mapping (8 × 16 electrodes per serosal) was performed in 4 anesthetized hounds. Baseline recordings (21 ± 8 minutes) were followed by intravenous injection of glucagon (0.5 mg per dose) and further recordings (59 ± 15 minutes). Blood glucose levels were monitored manually using a glucose sensing kit at regular 5-minute intervals. Slow wave activation maps, amplitudes, velocity, anisotropic ratio, and frequency were calculated. Differences were compared between baseline and post glucagon injection.
RESULTS
Baseline slow waves propagated symmetrically and antegrade. The blood glucose levels were increased by an average of 112% compared to the baseline by the end of the recordings. All subjects demonstrated elevated incidence of slow wave dysrhythmias following injection compared to the baseline (48 ± 23% vs 6 ± 4%, P < 0.05). Dysrhythmias arose simultaneously or independently on anterior and posterior serosa. Spatial dysrhythmias occurred before and persisted after the onset and disappearance of temporal dysrhythmias.
CONCLUSIONS
Infusion of glucagon induced gastric slow wave dysrhythmias, which occurred across a heterogeneous range of patterns and frequencies. The spatial dysrhythmias of gastric slow waves were shown to be more prevalent and persisted over a longer period of time compared to the temporal dysrhythmias.

Keyword

Electrophysiology; Gastrointestinal tract; Hyperglycemia; Interstitial cells of Cajal; Myoelectric complex, migrating

MeSH Terms

Blood Glucose
Electrodes
Electrophysiology
Gastrointestinal Tract
Glucagon
Glucose
Hyperglycemia
Incidence
Injections, Intravenous
Interstitial Cells of Cajal
Myoelectric Complex, Migrating
Serous Membrane
Blood Glucose
Glucagon
Glucose