Metoclopramide has no effect on abdominal activity of sestamibi in myocardial SPET

It has been suggested that metoclopramide may reduce artefacts caused by in testinal activity superimposed on myocardial uptake of MIBI SPET. This stud y compared the abdominal activity of MIBI in patients given metoclopramide versus a control group. Forty-seven patients with normal scintigrams or wit h completely normal inferior wall perfusion underwent rest Tl-201+ stress M IBI testing. Twenty-four patients arbitrarily received 10 mg metoclopramide orally 45 min before the MIBI injection and 23 patients no metoclopramide. The patients were divided according to the stress performed: 23 patients h ad exercise and 24 patients dipyridamole infusion, and a comparison was don e between patients with metoclopramide and those without. Myocardial and ab dominal activity were assessed at 15 and 60 min on three separate projectio ns and the mean myocardium-to-abdomen ratios were computed. The ratio was 1 .30 +/- 0.19 and 1.57 +/- 0.23 in the patients with exercise and metoclopra mide versus 1.36 +/- 0.18 and 1.64 +/- 0.23 in the patients with exercise a lone at 15 and 60 min respectively. The ratio was 0.92 +/- 0.13 and 1.21 +/ - 0.21 in the patients with dipyridamole infusion and metoclopramide versus 1.02 +/- 0.17 and 1.33 +/- 0.16 in the patients with dipyridamole alone at 15 and 60 min respectively. These differences were not statistically signi ficant. In conclusion, metoclopramide has no effect on MIBI abdominal activ ity and is not recommended in routine practice. ((C) 1999 Lippincott Willia ms & Wilkins).