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

It has been suggested that metoclopramide may reduce artefacts caused by intestinal activity super-imposed on myocardial uptake of MIBI SPET. This study compared the abdominal activity of MIBI in patients given metoclopramide versus a control group. Forty-seven patients with normal scintigrams or with completely normal inferior wall perfusion underwent rest 201T1 + stress MIBI 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 had exercise and 24 patients dipyridamole infusion, and a comparison was done between patients with metoclopramide and those without. Myocardial and abdominal activity were assessed at 15 and 60 min on three separate projections 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 metoclopramide versus 1.36 +/- 0.18 and 1.64 +/- 0.23 in the patients with exercise alone 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 significant. In conclusion, metoclopramide has no effect on MIBI abdominal activity and is not recommended in routine practice.