Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

To clarify the influence of body position on exercise prescription, 14 men (mean age +/- standard deviation 60.0 +/- 6.1 years) with coronary artery disease who underwent randomized recumbent and upright cycle ergometer tests to volitional fatigue were studied. At 100 watts, heart rate (HR), systolic blood pressure, oxygen consumption (VO2), rate pressure product and rating of perceived exertion were greater (p less than 0.05) in the upright than in the recumbent position. At peak exercise, however, these variables were not significantly different. Regressions of relative HR versus VO2 for recumbent and upright cycle ergometry were comparable: y = 1.24x - 32.7 and y = 1.26x - 31.5, respectively, where y = % maximal VO2, and x = % maximal HR. These findings indicate that recumbent exercise prescriptions may be based on the peak HR and VO2 values obtained during upright cycle ergometry, and vice versa. However, differences in the cardiorespiratory responses at submaximal exercise preclude the interchangeability of upright and recumbent training work rates.
 ...
PMID:Physiologic responses to recumbent versus upright cycle ergometry, and implications for exercise prescription in patients with coronary artery disease. 172 65

This prospective study of symptom-limited supine ergometry was conducted to determine the contributions of right ventricular (RV) and left ventricular (LV) systolic function to the exercise capacity of a cohort of patients with coronary artery disease (CAD). Patients with unstable angina, angiographically proven CAD (n = 53) and stable symptoms after medical therapy or angioplasty were included. Documented myocardial infarction (greater than or equal to 2 weeks before exercise) was present in 43 of 53 patients. Angina was the limiting symptom in 11 of 53; the other 42 stopped exercise with dyspnea or fatigue, or both. Oxygen consumption was measured on-line during exercise with a metabolic cart. RV ejection fraction and LV ejection fraction were measured by validated methods from gated blood pool radionuclide ventriculography. There were weak but statistically significant correlations between exercise oxygen consumption and exercise RV ejection fraction (r = 0.30, p less than 0.05) and between exercise oxygen consumption and exercise LV ejection fraction (r = 0.38, p less than 0.01). Multivariate regression analysis, including exercise RV ejection fraction, exercise LV ejection fraction and exercise heart rate versus exercise oxygen consumption revealed a better relation (r = 0.48, p less than 0.005) than any variable in univariate regression. The values of RV and LV ejection fraction at rest did not correlate significantly (r = 0.2, difference not significant), but the exercise values did correlate weakly (r = 0.41, p less than 0.01). The reserve of LV ejection fraction, defined as exercise minus rest value, correlated weakly with exercise oxygen consumption (r = 0.32, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Left and right ventricular systolic function and exercise capacity with coronary artery disease. 202 97

Cardiovascular rehabilitation is defined as the process of development and maintenance of a desirable level of physical, social, and psychologic functioning after the onset of a cardiovascular illness. Patient education, counseling, nutritional guidance, and exercise training play prominent roles in the process of rehabilitation. Benefits from cardiac rehabilitation include improved exercise capacity and decreased symptoms of angina pectoris, dyspnea, claudication, and fatigue. Recent pooled data regarding exercise training after myocardial infarction demonstrated a 20 to 25% reduction in mortality and major cardiac events. Exercise training may result in an improvement in systemic oxygen transport, a reduction in the myocardial oxygen requirement for a given amount of external work, and a decrease in the extent of myocardial ischemia during physical activity. The efficacy of modification of risk factors in reducing the progression of coronary artery disease and future morbidity and mortality has been established. Herein we review the history, current practice and results, and future challenges of cardiovascular rehabilitation.
 ...
PMID:Cardiovascular rehabilitation: status, 1990. 219 53

The recently developed myocardial agent methoxy-isobutyl-isonitrile (MIBI), labelled to 99mTc, allows one to evaluate global and regional ventricular function as well as myocardial perfusion by means of a single exercise stress test, significantly increasing diagnostic accuracy for coronary artery disease. Between September 1988 and March 1989, 407 patients with either suspected or already ascertained coronary artery disease underwent simultaneous assessment of regional ventricular function with first pass radionuclide angiography, and of myocardial perfusion with single photon emission computerized tomography, by means of 2 injections of 99mTc-MIBI at rest and at peak of the same exercise test. Out of these patients, 56 (52 men and 4 women, whose mean age was 57 +/- 7 years) underwent coronary angiography within 6 months of radionuclide examination and were included in the study. There were 13 1-vessel, 26 2-vessel and 17 3-vessel disease patients. Thirty-six of them had had a previous (greater than 6 months old) myocardial infarction, on the anterior wall in 16 patients, on the inferior wall in 20. In all patients a computerized bicycle stress test was performed; interruption criteria were ST segment depression greater than or equal to 1 mm in 27 patients (48%), the achievement of a heart rate greater than 85% of maximal age-predicted heart rate in 12 patients (22%) and fatigue in 17 patients (30%). Scintigraphic results were compared to angiographic findings: global sensitivity and specificity of the simultaneous evaluation were 82% and 81%, respectively, vs 95% and 56% of functional results and 85% and 71% of perfusion results, respectively. Regional analysis was also performed, by dividing scintigraphic images into the territories supplied by the 3 main coronary vessels, i.e., left anterior descending artery (LAD), left circumflex artery (LCx) and posterior descending artery (PD). On LAD territory the simultaneous evaluation achieved a sensitivity of 88% and a specificity of 63%, vs 98% and 38% of functional analysis and 88% and 50% of perfusional analysis, respectively. On LCx territory sensitivity and specificity were respectively 71% and 96%, vs 91% and 64% of function, and 77% and 96% of perfusion alone. On PD territory sensitivity was 85%, vs 94% and 91%, respectively; specificity was 73%, vs 55% and 55%, respectively. Combined functional and perfusional analysis achieved a 68% sensitivity in identifying less than or equal to 75% coronary narrowings, and a 90% sensitivity for greater than 90% narrowings.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[Improvement in the accuracy of diagnosis of ischemic heart disease with simultaneous radioisotope evaluation of regional myocardial function perfusion and an exercise test]. 220 96

Various non-invasive methods exist for evaluating the cardiac status of patients presenting for peripheral vascular surgery. Methods involving exercise on a treadmill are frequently used, but adequate testing may be limited in amputees and patients with severe claudication or rest pain. An alternative means of exercise is the arm ergometer. A study of 130 patients subjected to arm ergometer exercise testing before peripheral vascular surgery was undertaken. A control group of 29 consecutive patients had coronary angiography. ECG exercise testing using the arm ergometer showed a sensitivity for detecting coronary artery disease of 46% and a specificity of 100%. In total, 42 tests were positive, 21 on patients with no symptoms of ischaemic heart disease and no resting ECG changes indicative of ischaemia, and 4 in patients with atypical angina. Muscle fatigue proved a problem, especially in women; while the accuracy of the test did not decline in patients over the age of 60 years when compared with those under this age.
 ...
PMID:The arm ergometer exercise test for evaluating coronary artery status in patients presenting for peripheral vascular surgery. 228 76

Mortality from coronary artery disease is a common problem in treated hypertensive patients, and these people have a high prevalence of elevated cholesterol levels. A study was undertaken to determine whether cholesterol could be lowered effectively without major side effects in patients with treated hypertension. Forty-nine patients (mean age 67.6 years) with cholesterol greater than 5.5 mmol/l were placed on a reduced-fat (less than 30% of calories from fat with a ratio of polyunsaturated to saturated fats of less than 1) diet for 3 months. If the cholesterol was between 5.5 and 7.5 mmol/l and total cholesterol divided by high-density lipoprotein cholesterol was greater than 4.5, the patients were randomly allocated either to the simvastatin (24 patients) or the placebo group (25 patients). Diet and placebo caused minor and insignificant falls in cholesterol and no change in triglycerides or lipids. Treatment with simvastatin reduced cholesterol levels from 6.85 to 4.75 mmol/l (P less than 0.001), triglycerides from 2.7 to 2.1 mmol/l (P less than 0.01), low-density lipoproteins from 4.6 to 2.6 mmol/l (P less than 0.001) and high-density lipoproteins rose from 1.09 to 1.18 mmol/l (P less than 0.01). Total cholesterol divided by high-density lipoprotein cholesterol fell from 6.3 to 4.0 (P less than 0.001). The drug was well tolerated and the side-effect profile did not differ from the placebo in clinical or biochemical events. The active drug was stopped in one patient (abdominal pain, dizziness, headache, tiredness) and in two patients taking the placebo (elevated creatine phosphokinase, cardiovascular collapse). Simvastatin effectively lowered total cholesterol and improved the lipoprotein profile. The dose required in most patients was 40 mg/day. Simvastatin may be an acceptable drug to improve the lipoprotein profile in order to determine whether this improves the prognosis in patients treated for hypertension.
 ...
PMID:Simvastatin in the treatment of hypercholesterolaemia in patients with essential hypertension. 233 14

Body surface ST integral maps were recorded in 36 coronary artery disease (CAD) patients at: rest; peak, angina-limited exercise; and, 1 and 5 min of recovery. They were compared to maps of 15 CAD patients who exercised to fatigue, without angina, and eight normal subjects. Peak exercise heart rates were similar (NS) in all groups. With exercise angina, patients with two and three vessel CAD had significantly (p less than 0.05) greater decrease in the body surface sum of ST integral values than patients with single vessel CAD. CAD patients with exercise fatigue, in the absence of angina, had decreased ST integrals similar (NS) to patients with single vessel CAD who manifested angina and the normal control subjects. There was, however, considerable overlap among individuals; some patients with single vessel CAD had as much exercise ST integral decrease as patients with three vessel CAD. All CAD patients had persistent ST integral decreases at 5 min of recovery and there was a direct correlation of the recovery and peak exercise ST changes. Exercise ST changes correlated, as well, with quantitative CAD angiographic scores, but not with thallium perfusion scores. These data suggest exercise ST integral body surface mapping allows quantitation of myocardium at ischemic risk in patients with CAD, irrespective of the presence or absence of ischemic symptoms during exercise. A major potential application of this technique is selection of CAD therapy guided by quantitative assessment of ischemic myocardial risk.
 ...
PMID:Exercise body surface potential mapping in single and multiple coronary artery disease. 234 18

Dynamic cardiomyoplasty has been used to correct cardiac defects, augment contraction of weakened myocardium, and support circulation of end-stage heart disease patients by using their own skeletal muscle after electric conditioning. Five patients, each with a history of myocardial infarction and diffused coronary artery disease, underwent the application of the left latissimus dorsi muscle over the anterolateral wall or around the ventricles. In all patients the left latissimus dorsi muscle was dissected free from all insertions with careful preservation of the thoracodorsal nerve and vessels. The freed muscle flap was internalized into the thoracic cavity with the humeral tendinous end of the muscle sutured to the periosteum of the second or third rib after subperiosteum resection of a portion of the rib. The muscle flap was used in three of the five patients for ventricular wall repair after aneurysmectomy. In the other two patients the muscle was applied over the ventricles for functional augmentation. The skeletal muscle was electrically conditioned to contain mainly fatigue-resistant muscle fibers and was stimulated to contract synchronously with the heart. All patients survived the operation, with immediate improvement of ventricular function for those who had had aneurysmectomy. A significant increase in ejection fraction was observed in three of the five patients when the pacemaker was turned on. One patient died of sudden ventricular arrhythmia 2 months after the operation. The last patient is doing well at 6 weeks after operation. The first patient has been followed up for more than 3 years and continues to do well.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Dynamic cardiomyoplasty in patients. 235 78

Exercise tolerance in patients with normal cardiac function can improve with an exercise program. Controversy exists whether this is also true for patients with congestive heart failure (CHF). The limiting symptoms in patients with CHF are shortness of breath and fatigue. Hemodynamic parameters do not correlate well with exercise capacity in patients with CHF. These symptoms may be more related to factors that cause fatigue during exercise than to hemodynamic parameters or even to changes in pulmonary capillary pressure. The factors that cause symptoms include an increased lactate production and metabolic and blood flow abnormalities in the skeletal muscle. Exercise training can improve vasodilation and oxidation capacity, thereby reducing lactate production. Exercise programs may improve exercise capacity in the majority of patients with CHF due to coronary artery disease or idiopathic cardiomyopathy. However, certain patients with ischemia and with anterior infarctions may experience a detrimental effect on their cardiac function. Further studies are needed to better enable recognition of these patients but until this is possible, good clinical judgement must suffice.
 ...
PMID:Cardiac rehabilitation for heart failure patients. 268 76

It is unclear whether improvements in short-term (30 s) exercise capacity are associated with the increased aerobic exercise tolerance frequently observed in cardiac patients following training. Carefully selected patients with documented coronary artery disease were randomly allocated either to a control group (N = 10) or to 12 wk of endurance exercise training (N = 12); both progressive incremental cycle ergometer testing (maximal power output and peak VO2) and 30 s maximal isokinetic cycle ergometry (peak power, total work, and fatigue index) were measured on entry into the study and 12 wk later. Initial maximum performance measures in progressive incremental exercise and in maximal short-term isokinetic cycling were similar in both groups. Following the training program, maximum power output measured during progressive incremental exercise increased by 21% (P less than 0.005) and peak VO2 increased by 18% (P less than 0.005) in the exercise group, but they were unchanged in the control group. Isokinetic peak power and total work improved by 14% (P less than 0.001) and 11%, respectively, in the exercise group, whereas there were corresponding reductions of 6 and 8% in the control subjects, with little change in fatigue index in either group. The similar relative increases in isokinetic peak power and peak VO2 suggest that improvement in short-term exercise capacity may be an important contributor to the improvement in aerobic exercise tolerance frequently observed in cardiac patients undergoing an endurance exercise program.
 ...
PMID:Improvement in maximal isokinetic cycle ergometry with cardiac rehabilitation. 273 81


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>