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

A single-blind study of prenalterol 20-200 mg daily in a slow-release tablet preparation and a placebo was performed in 15 patients with moderate to severe congestive heart failure (NYHA II-IV) to evaluate the haemodynamic and clinical effects of oral prenalterol. Non-invasive parameters in the measurement of cardiac output, stroke volume, pre-ejection period index (PEPI), PEP/LVET ratio, ejection fraction and mean Vcf were significantly improved, indicating beneficial effects of prenalterol on cardiac contractility. Systolic blood pressure, heart rate and rate-pressure product were slightly increased at rest but were considerably lower during exercise. Arrhythmogenecity was not seen in the patients studied. Subjective improvement was noted in the majority of patients as evidenced by a decreased frequency of dyspnoea, fatigue and angina. Unwanted effects, such as palpitations and transmitted arm pulsations, were transient and disappeared with dose adjustment, while the inotropic effect of the medication was maintained. The clinical response appeared to be sustained for up to 2 weeks of treatment, indicating non-development of tachyphylaxis.
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PMID:Effects of prenalterol administered orally in patients with congestive heart failure. 612 90

The aortic root as a functional unit includes the sinuses of valsalva, valve ring, the leaflets and the commissures. This unit is impaired by the insertion of a bioprosthetic three-leaflet valve. Moreover, bioprostheses fail because of fatigue and flexion stresses. Consequently a program was started for free-handed orthotopic transplantation of allogeneous aortic valves at the Department of Cardiovascular Surgery, University Kiel. A series of 16 consecutive antibiotic, sterilized aortic valve allografts were transplanted in the last 12 months without death. There were 4 females and 12 males between 18 and 63 years old (mean 47.9). The dominant lesion was aortic regurgitation (in 9), stenosis (in 3) and mixed (in 4). Out of the 13 patients who maintained their allografts, 10 (77%) were in class III and 3 (23%) in class IV of the NYHA functional classification. Four patients improved from class III to class I, and 9 from class III and IV to class II of the NYHA functional classification after surgery. All patients except one had postoperative recatheterization including videodensitometry to quantitate the regurgitation, expressed as a regurgitant fraction ( RGF ) in percent of the total stroke volume of the left ventricle, and pressure measurements to determine systolic gradients across the aortic valve allograft, 3 to 6 days and 9 months after surgery. Eleven (68.75%) patients had no regurgitation, 2 (12.5%) patients had trivial aortic regurgitation with RGF of 7% and 10%, respectively. Three (18.75%) patients had severe aortic valve regurgitation with RGF between 40% and 60% due to technical errors and their allografts had to be replaced.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Orthotopic transplantation of aortic valve allografts. Early hemodynamic results. 620 16

This study attempts to define cardiac performance at rest and during exercise in patients with untreated thyrotoxicosis. We studied 7 women and 3 men, aged 23 to 59 years (40 +/- 10, mean +/- standard deviation [SD]) and compared the results with those obtained in 12 normal subjects. In patients with thyrotoxicosis, the rhythm was sinus and the only untoward symptom was palpitations; the resting electrocardiographic results were normal in 8 patients and showed left ventricular hypertrophy in 2 patients; the left ventricular ejection fraction and volumes (measured by radionuclide ventriculography) were normal at rest. During exercise, 1 patient had dyspnea and 7 had leg fatigue; 2 were asymptomatic. Also, 7 patients had greater than or equal to 5% increase in left ventricular ejection fraction, 2 had no change, and 1 had a decrease. In all 10 patients, the exercise ejection fraction was greater than or equal to 60%. All normal subjects had a greater than or equal to 5% increase in ejection fraction during exercise. There were no significant differences at rest between patients with thyrotoxicosis and normal subjects in blood pressure, ejection fraction, end-diastolic volume, stroke volume, end-systolic volume, or cardiac output, but the heart rate was significantly higher in patients with thyrotoxicosis (91 +/- 10 versus 80 +/- 12 beats/min, p less than 0.05). During exercise, there were no significant differences between patients with thyrotoxicosis and normal subjects in blood pressure, end-diastolic volume, stroke volume, end-systolic volume, or cardiac output. The exercise ejection fraction was significantly lower in patients with thyrotoxicosis than in normal subjects (68 +/- 10% versus 75 +/- 4%, p less than 0.05). Cardiac performance is normal at rest in patients with thyrotoxicosis, but during exercise abnormal left ventricular reserve occurs in some patients.
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PMID:Cardiac performance in thyrotoxicosis: analysis of 10 untreated patients. 621 43

Labetalol is a competitive antagonist of alpha 1-, beta 1-, and beta 2-adrenergic receptors. The hemodynamic effects of the drug include reduced blood pressure, heart rate, and peripheral resistance, with little change in resting cardiac output or stroke volume. In open trials and controlled studies, labetalol was an effective antihypertensive. Labetalol compared favorably with beta-blockers alone or in combination with vasodilators, for the treatment of hypertension. Reductions in heart rate are less pronounced with labetalol as compared with propranolol. Labetalol produces rapid reductions in blood pressure when administered intravenously for severe hypertension. The most frequent adverse reactions to the drug include fatigue, postural symptoms, headache, and gastrointestinal complaints. Labetalol may prove advantageous when vasodilation in addition to beta-blockade is desired, or for selected patients experiencing adverse effects attributable to beta-blockade. Until the clinical profile of labetalol is better defined, the use of the drug should be limited.
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PMID:Labetalol. 635 58

The mitral apparatus is a complex structure composed of several components, each of which can be affected by a variety of diseases, resulting in mitral regurgitation. The physiologic consequences of mitral regurgitation include reduced forward stroke volume; increased left atrial volume and pressure; and reduced resistance to left ventricular ejection. The latter explains why indices of systolic left ventricular function (ejection fraction) are often increased early in the course of mitral regurgitation. With the insidious development of mitral regurgitation, the left atrium dilates to accommodate the increase in volume, thereby reducing the atrial pressure. However, with the acute development of mitral regurgitation into a nondilated left atrium, pressure rises rapidly, producing pulmonary edema. The predominant clinical symptoms in chronic mitral regurgitation of dyspnea and fatigue result from pulmonary venous hypertension and low cardiac output. The cardinal physical finding is a mitral systolic murmur. Since the murmur can assume various configurations, the most reliable way to establish its correct origin is by bedside physiologic maneuvers. Typically, in the beat following a premature contraction or after a long pause during atrial fibrillation, the murmur of mitral regurgitation is unchanged in intensity, but murmurs due to left ventricular outflow obstruction increase. Also, isometric handgrip exercise increases the intensity of the murmur and a Valsalva maneuver decreases it during the strain phase. Echocardiography is the most useful noninvasive technique for evaluating patients with mitral regurgitation. Visualization of the mitral apparatus may establish the etiology of regurgitation, and measurement of left atrial size and left ventricular size and performance is useful for assessing the functional significance of the lesion. Doppler echocardiography can establish the diagnosis of mitral regurgitation in difficult cases with multi valve disease and can estimate the severity of the regurgitation. Cardiac catheterization and angiography are usually reserved for the patient being considered for valvular surgery. The natural history of chronic mitral regurgitation is characterized by slowly progressive symptoms, and often the onset of disabling symptoms is the result of irreversible left ventricular dysfunction. Medical therapy consists of digitalis, diuretics, and vasodilators for symptomatic patients. When symptoms occur despite this therapy, valvular surgery should be considered before left ventricular function becomes abnormal.
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PMID:Mitral valve regurgitation. 637 82

The effects of a simulator flight task on the heart rate variation (HRV) and hemodynamic variables were studied in nine pilots with instrument flight ratings. An electrocardiogram (ECG), phonocardiogram (PCG), and impedance cardiogram (ICG) were recorded continuously during three successive flights. Indices of HRV, power spectra, and autocorrelograms were computed from the R-R interval signal. Stroke volume (SV), cardiac output (CO), and systolic time intervals (STI) were determined by means of the ECG, PCG, and ICG. A scaling method for a subjective evaluation of tiredness, effort, and success during the flight was used. The repeats of the flight task decreased the heart rate (HR), CO, and cardiac index (CI). The different phases of the flight altered the HR (mean 97 min-1, S.E.M. 4 min-1), total HRV (RMSM) (mean 33 ms, S.E.M. 5 ms), and the periodic HRV. Subjectively, the pilots felt only moderate stress. The subjectively evaluated tiredness was significantly associated with the STI. Moderate informative stress in the flight simulator affected the chronotropic parameters of the heart. The inotropic state of the heart was not affected by the different phases of the flight but possibly by the diminishing sympathetic drive with accommodation during the repeats.
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PMID:Heart rate variability, cardiac mechanics, and subjectively evaluated stress during simulator flight. 662 75

Twelve patients with severe chronic congestive heart failure (CHF) received prazosin in a dose of 4 to 20 mg daily for a period of 2 months, in addition to cardiac glycoside and diuretic drugs. After this treatment left ventricular end-diastolic diameter decreased from 5.7 +/- 0.4 to 5.4 +/- 0.4 cm (p less than 0.001), left ventricular end-systolic diameter decreased from 4.3 +/- 0.5 to 4 +/- 0.5 (p less than 0.001), left ventricular stroke excursion increased from 1.03 +/- 0.11 to 1.27 +/- 0.15 cm (p less than 0.01), the ejection fraction increased from 24.9 +/- 2.1 to 32.2 +/- 2.8 (p less than 0.001) and the mean velocity of circumferential fiber shortening increased from 0.68 +/- 0.06 to 0.79 +/- 0.08 circumferences/s (p = 0.06). Prazosin treatment clearly relieved dyspnea and fatigue. Three patients improved from Class IV to Class III, four patients improved from Class IV to Class II and 3 patients from Class III to Class II.
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PMID:The effects of prazosin in severe congestive heart failure. An echocardiographic study. 671 45

The delay between the stimulus and the voluntary eye saccade is the only parameter of the saccadic system which can be measured by using standard apparatus. Taking manually the measurements made on records obtained by using minicomputer; the authors show that such manual measurement of latencies is easy and yet sufficiently accurate to be of great clinical value. The latencies of voluntary saccades are normal in peripheral pathology (less than 250 milliseconds). Latencies of voluntary saccades are significantly increased in extrinsic brain stem lesions: tumours (in particular ponto cerebellar tumours), meningitis, head injury; but the velocity of the saccade is normal. This effect goes in parallel with impairement of the smooth pursuit. In intrinsic brain stem lesions (multiple sclerosis, acute brain stem stroke, oculomotor paralysis) latencies are increased bilaterally and above all, there is a significant slowing of the saccade. The role of fatigue increased latencies in some patients of this series. Two populations can be discerned in vestibular neuritis: one normal and one with abnormal smooth pursuit and increased saccadic latencies.
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PMID:[Measurement of the latencies of voluntary and corrective ocular saccades. Value in otoneurology]. 684 74

Blood pressure, heart rate, and echocardiographic parameters of left ventricular size and shortening were measured both under baseline conditions and during handgrip exercise (50% maximum handgrip effort held to fatigue) in 20 normal women (20 through 29 years of age). As a group, there was a significant increase in heart rate (72 +/- 10 vs 83 +/- 12; P less than .001), systolic blood pressure (111 +/- 8 vs 133 +/- 14 mm Hg; P less than .001), diastolic blood pressure (67 +/- 8 vs 89 +/- 12 mm Hg; P less than .001), and calculated cardiac output (4.3 +/- 1.5 vs 5.2 +/- 1.7 liters/minute; P less than .005). There was no significant change in left ventricular internal dimension in diastole or systole, shortening fraction, or calculated stroke volume. The average group response of an increase in cardiac output secondary to an increase in heart rate is similar to that of male subjects in their second decade. Individual variability in responses was of specific interest since only three of the 20 women demonstrated a totally characteristic response to handgrip exercise. Handgrip exercise in young women may not provide a uniformly characteristic response from which to predict hemodynamic changes in a given individual and may lead to clinical misinterpretation if appropriate caution is not used.
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PMID:Handgrip exercise in normal young women: a noninvasive cardiovascular assessment. 707 32

The purpose of this study was to investigate the relationship between exercise capacity and resting left ventricular function assessed by several non-invasive methods in patients with old myocardial infarction. Subjects were 25 male patients whose endpoint was either dyspnea or general fatigue at the symptom-limited maximal graded treadmill exercise test according to Bruce protocol. The indices obtained by non-invasive cardiac examinations included left ventricular fractional shortening (% FS), scintigraphic infarct size (% SIS) by 201Tl myocardial scintigraphy and PEP/ET (so-called Weissler's index). A significant correlation of exercise duration with % FS (r = 0.67, p less than 0.001) or with % SIS (r = -0.55, p less than 0.02) indicated that the more was impaired resting left ventricular function, the more was decreased exercise capacity. Also, a significant correlation of systolic blood pressure at the end-point in exercise test with % FS (r = 0.58, p less than 0.005) or with % SIS (r = 0.69, p less than 0.001) indicated that inadequate blood pressure response might be partially attributed to impaired left ventricular function during exercise. The response of heart rate at the Bruce protocol stage I correlated with % FS (r = -0.67, p less than 0.001) and with % SIS (r = 0.53, p less than 0.02), respectively. These findings may be interpreted as chronotropic compensatory mechanism for limited stroke volume during exercise in patients with imparied left ventricular function. Thus, it was concluded that resting left ventricular function assessed by non-invasive cardiac examinations may predict exercise capacity prior to the test to some extent. These informations can be utilized for the decision of the planning at cardiac rehabilitation and also for the guidance in daily activities. Additionally, low level exercise test with treadmill is considered to be valuable for screening cases with impaired left ventricular function in old myocardial infarction.
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PMID:[Comparison of exercise capacity with resting left ventricular function evaluated by various non-invasive methods in patients with old myocardial infarction]. 711 3


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