Abnormal SPECT myocardial perfusion imaging during periods of obstructive sleep apnea in morbid obese patients without known heart disease.
OBJECTIVE
Determine the myocardial perfusion characteristics in obstructive sleep apnea and its possible role in cardiovascular damage.


METHODS
Fourteen patients from the Obesity Clinic weighing less than 130 kg underwent myocardial perfusion studies using single photon emission computed tomography with technetium 99m-labeled sestamibi during nighttime polysomnographic recordings. Coronary angiograms were performed on patients with suspect of severe coronary obstruction according nighttime myocardial perfusion studies or pharmacological stress carried out during waking hours.


RESULTS
All 14 patients manifested myocardial perfusion defects during sleep, affecting an average of 5.5 segments/patient, although only 8 presented ischemic ST segment changes and none demonstrated rhythm or conduction disturbances. Angiographic examination of the 10 patients with the most severe perfusion defects did not reveal significant coronary obstruction, and fewer perfusion defects were documented during daytime scintigraphy.


CONCLUSIONS
In obese patients with obstructive sleep apnea, myocardial perfusion defects appear to occur with highest frequency and severity during nighttime sleep, justifying further investigation in a larger number of patients with obstructive sleep apnea and more significant obesity.
Orea-Tejeda
Arturo
A
Department of Nuclear Medicine, Obesity Clinic, Instituto Nacional de Ciencias Medicas y Nutrición Salvador Zubirán, Mexico City. artorea@yahoo.com.mx
Valencia-Flores
Matilde
M
Castillo-Martinez
Lilia
L
Rebollar-Gonzalez
Verónica
V
González-Barranco
Jorge
J
Castaño
Alejandra
A
Asensio
Enrique
E
Dorantes-Garcia
Joel
J
Sepulveda-Mendez
Jesús
J
Oseguera-Moguel
Jorge
J
García-Ramos
Guillermo
G
Cano
Angeles
A
D003326:Coronary Circulation; D005260:Female; D006321:Heart / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications*; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology*; D015899:Tomography, Emission-Computed, Single-Photon