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Query: UMLS:C0015672 (fatigue)
 51,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Within the last 10 years the indications for a therapeutic regimen with beta-blocking-agents have been differentiated: coronary heart disease with angina pectoris (interval regimen), essential hypertension, especially in younger persons; hyperkinetic heart syndrome; thyreotoxikosis, symptomatic therapy; heart rhythm disorders, extrasystolic or tachysystolic; neurologic-psychiatric diseases. The development of the newer beta-blocking-agents has effected different kinetic data (f.i. long acting effects of Tenormin) and a increased cardioselectivity. The recommendations for the therapeutic regimen have to be outlined to the underlying diseases. The sensitivity against the drugs depends on remarkable individual differences, with the consequence of a careful and low dosage in the beginning in each case. The side-effects of beta-blocking-agents are presumably: bradycardia, bronchospasm, fatigue, adynamia, myocardial insufficiency, gastrointestinal symptoms, hypoglycemia, hypotension.
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PMID:[Therapy with beta-blocking-agents (author's transl)]. 3 43

224 patients with coronary heart disease, hypertension, disturbances of cardiac rhythm or hyperkinetic heart syndrome were treated with the cardioselective beta-blocker Talinolol (Cordanum) for a period up to 3 years. In 239 examinations in intravenous or peroral application of this medicament we controlled among others the appearance of side effects. This test was carried out with the help of standardised questionings and clinical controls. Apart from registrations of ECG and blood pressure clinico-chemical investigations were included and in the long-term experiment also tests by dermatologists, otorhinolaryngologists and ophthalmologists. In the total number of patients the proportion of side appearances was 17,6%, in the long-term experiment (100 patients with on an average 12.9 months) 7%. The symptoms most frequently cited in the initial phase, such as fatigue, weakness, insomnia and nausea receded within 4 weeks apart from few exceptions. There did not appear any essential bradycardic disturbances of the cardiac rhythm, just as little were references to disadvantageous reactions in the sense of a practolol syndrome.
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PMID:[Long-term studies on the beta blocker talinolol (cordanum) with special reference to side effects]. 3 87

In order to determine their exercise tolerance, 20 patients with artificial ventricular demand pacemakers below the age of seventy were studied by bicycle ergometry. Only 30% of the patients showed a normal exercise tolerance according to the criteria by Kaltenbach, while 70% stopped the test prematurely because of leg fatigue, dyspnoe or chest pain. In terms of their exercise tolerance, there was no difference between patients who developed normal sinus rhythm or rapid atrial fibrillation during the exercise and those who remained at the fixed pacemaker rate throughout the test. It is concluded, therefore, that the exercise tolerance of pacemaker-patients is not only limited by the fixed heart rate but mainly by the underlying heart disease (coronary heart disease, cardiomyopathy, hypertensive heart disease etc.) and the general physical condition of the patients. In an age-matched control group of 20 patients 50% showed a normal exercise tolerance and the duration of exercise in this group was only slightly longer (21%) than in the pacemaker-group.
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PMID:[Exercise tolerance of patients with artificial cardiac pacemakers (author's transl)]. 54 95

Repeat exercises (three hours apart) on a bicycle ergometer and a vertical step-ladder were performed in a randomised series on 79 subjects: 13 doctors, 44 patients and 22 sportsmen. Duration of exercise was on average 250% longer in the three groups on the step-ladder than the bicycle. Correspondingly, exercise-pulse sums, recovery-pulse sums and exercise indices were two-and-a-half to three times higher than on bicycle ergometry. As a sign of comparability of the exercise by the two methods there was, on average, no significant difference with regard to the final heart rate, although duration of exercise was longer on the step-ladder. 67% of subjects discontinued the exercise because of peripheral muscle fatigue on the bicycle ergometer, compared with only 8% on the step-ladder. During bicycle ergometry lactate concentration rose by 6.7 mmol/l compared with only 0.78 mmol/l during step-ladder exercise. These results indicate that the value of bicycle ergometry exercise is limited by muscle fatigue in the legs: step-ladder exercise can be extended much longer. The practical significance is that patients with coronary heart disease especially have symptoms and/or ECG changes of ischaemia only at higher levels of physical exercise.
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PMID:[Comparison of bicycle ergometry and step-ladder exercise (author's transl)]. 76 18

A study was conducted to test the hypothesis that Type A (coronary-prone) individuals would show greater suppression of subjective fatigue than Type B (non-coronary-prone) individuals in order to persist at a tiring but challenging task. Type A and Type B college students completed a Balke treadmill test (at a walking pace) while rating their fatigue at 2-minute intervals. Each subject also completed another treadmill test (at a running pace) that was designed to assess maximum aerobic capacity. Subjects' aerobic capacities and their aerobic performance levels attained on the Balke test were determined by analysis of expired air. Each subject's walking performance was scored as a proportion of his maximum aerobic capacity. Analysis of the resulting percentage values indicated greater effort among A's than B's. Moreover, the subjective fatigue ratings of A's were lower than those of B's. The results were discussed in terms of fatigue suppression as an instrumental response for attaining mastery over the environment. consideration was also given to the role of fatigue in the onset of coronary heart disease.
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PMID:The coronary-prone behavior pattern and the suppression of fatigue on a treadmill test. 127 Dec 20

A total of 1,431 patients (mean age 63.4 +/- 14.1) with pacemakers (96.2% VVI) primoimplanted between 1967 and 1985 were followed for a mean duration of 78.2 +/- 40 pacing months, with 0.6% loss to follow-up. Cumulative survival for 1, 3, and 10 years was 0.9427, 0.9136, and 0.7536, respectively. There was no significant difference in survival between atrioventricular block (AVB) and sick sinus syndrome (SSS) patients. In addition to age and gender, factors existent prior to implantation that independently affected prognosis included manifest coronary heart disease (CHD), congenital/acquired heart lesions, heart failure, noncardiac internal disease, syncope, and generalized fatigue. After implantation, the most important factor was generalized fatigue, then age, stroke, myocardial infarct (MI), gender (male), heart failure, and syncope. Patients with no underlying disease showed an extremely high cumulative survival (0.9173 at 10 years). Compared to the general population of Yugoslavia, the pacemaker patients showed a similar yearly mortality rate until 1981. After that, elderly males (70+) had a significantly lower yearly mortality than the matched population. Thus, in this large series of pacemaker patients followed into the most recent period with an extremely low loss to follow-up, short- and long-term survival was very high. Pacemaker patients of any age who are otherwise in good health have an excellent prognosis.
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PMID:Survival in 1,431 pacemaker patients: prognostic factors and comparison with the general population. 137 12

Excess fatigue is the most prevalent precursor of sudden cardiac death. This state may reflect prolonged tension or heart disease. In order to test the first explanation a prospective study was done among 3365 males, aged 45-59 years. This cohort was followed during an average period of 9.5 years. Exhaustion was assessed by the statement: 'At the end of the day I am completely exhausted mentally and physically'. Among those free of coronary heart disease at the beginning, 69 subjects died because of myocardial infarction. Data were analysed using Cox's regression analysis. The results showed a highly significant interaction between duration of follow-up and exhaustion upon the risk of cardiac death. The hazard ratios for exhaustion were 8.96, 6.33, 4.47 and 3.16 for the first 10, 20, 30 and 40 months of follow-up respectively. Thereafter the association between exhaustion and cardiac death is no more significant. It is argued that exhaustion before cardiac death does not reflect manifest heart disease but that an interaction between prolonged tension and subclinical levels of ischaemia may increase the risk of cardiac death.
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PMID:Exhaustion as precursor of cardiac death. 139 66

Sleep complaints and unusual sleep durations have been found to increase the risk for coronary heart disease. One explanation states that insomnia and excess fatigue on final waking are predictive for myocardial infarction because they are part of a state of 'vital exhaustion'. Sleep complaints and sleep durations, however, are usually assessed with retrospective self-report procedures. Such procedures must be interpreted with reserve because in insomniacs, a consistent disparity in the perception of habitual and current sleep has been observed. This caused us to question whether this phenomenon is present in exhausted males also. Two approaches were used. The first one consisted of a retrospective assessment of subjective sleep characteristics, the second one of self-monitoring these sleep characteristics during 21 days. In the second week, subjects slept in a laboratory. No disparity was found in how exhausted males perceive their habitual and current sleep. It appeared that sleep quality is worse and sleep duration is shorter in exhausted males. They also feel more sleepy and take longer naps during the day, indicating that their daytime functioning is impaired. Sleeping in a laboratory reduced time asleep and midsleep wake. Sleep quality, however, was essentially the same as at home. These findings made us conclude that it is not the intrusion of nocturnal wake times per se but more likely the impaired daytime functioning which is the reason for exhausted males to complain about their sleep.
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PMID:Vital exhaustion and perception of sleep. 161 84

The diagnostic potentialities of bicycle ergometry (BEM) and treadmill test were comparatively analysed in 57 males aged 37-64 years who were examined to detect coronary heart disease. In 34 cases, the results of BEM and treadmill test were consistent, of them 13 were positive, 15, negative, 3 intermediate, and 3 inadequate. With positive results, the treadmill test was more reliable than BEM in revealing the criteria for ischemia from statistically significantly more pronounced ST-segment depression at a lower threshold heart rate. Inconsistency of the BEM and treadmill test results was found in 23 cases. In 14 of 18 patients who had indefinite BEM results, the treadmill test allowed one to make a definite conclusive diagnosis, showing 6 positive and 8 negative results. This is accounted for by lower cases when the treadmill test was discontinued due to a hypertensive reaction of blood pressure or fatigue. The study indicated that the treadmill test was more sensitive and better tolerated than BEM.
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PMID:[Comparing the informative value of bicycle ergometry and treadmill tests in the evaluation of the coronary reserve]. 180 56

The prognosis of coronary patients in terms of the mortality of coronary heart disease shows a positive relation to the severity of clinical and functional diagnostic parameters. Thus exercise therapy should be monitored by criteria that take ischemia, the myocardial situation and rhythm disorders into account. These criteria should be reliable and should be easy to determine as well as to apply. For pragmatic reasons the non-invasive evaluation of findings and the diagnostic symptom-limited ergometer test are especially significant for dosage and monitoring of exercise therapy. Monitored exercise therapy is here understood to mean individually adjusted exercising by patients, and training thus has to be based on diagnostic findings. First existing complaints have to be analyzed and such findings as size of infarction in the ECG, heart volume in the X-ray, size and function of the left ventricle by echography, etc. checked. Afterwards maximum physical work capacity on a multistage bicycle ergometer test is measured with respect to the following termination criteria: a) subjective reports by the patient during exercise (e.g. onset and severity of angina pectoris, dyspnea and/or fatigue of the leg muscles) and b) objective criteria such as significant ischemic ST-depression, exercise-hypertension, age-related submaximal heart rate and significant rhythm disorders. An inverse correlation is found between measured maximum symptom-limited physical performance and the frequency of cardiac termination criteria; a comparable inverse correlation exists with heart volume: max. O2 pulse.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Can the training of coronary patients be monitored by readily measurable parameters?]. 191 21


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