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Cardiovascular Responses to Exercise Chapter Learning Outcomes • Graph and explain the pattern of response for the major cardiovascular variables during short and long-term, light to moderate submaximal aerobic exercise. • Graph and explain the pattern of response for the major cardiovascular variables during incremental aerobic exercise to maximum and during dynamic resistance exercise • Discuss the similarities and differences between the sexes in the cardiovascular response to the various classifications of exercise. Cardiovascular Responses to Acute Aerobic Exercise • Increases blood flow to working muscle • Involves altered heart function, peripheral circulatory adaptations – Cardiac output (A) • Heart rate (C) • Stroke volume (B) – Blood pressure (D) – Total peripheral resistance (TPR) (E) – Rate pressure product (RPP) (F) Figure 12.1, 12.4 & 12.7 Acute Responses to Submaximal Aerobic Ex Light to Moderate Moderate to Vigorous Steady State Exercise output = requirements • When the body can meet the metabolic and physiological demands during submaximal exercise, a “steady state” of equilibrium is achieved at values above resting. Acute Maximal Aerobic Ex Cardiovascular Responses: Cardiac Output (Q) • Q = HR x SV •Normal values – Resting Q ~5 L/min – Untrained Qmax ~20 L/min – Trained Qmax 40 L/min • Qmax a function of body size and aerobic fitness Cardiovascular Responses: Heart Rate (HR) • Normal ranges – Untrained RHR: 60 to 80 beats/min – Trained RHR: as low as 30 to 40 beats/min – Affected by neural tone, temperature, altitude • Anticipatory response: HR above RHR just before start of exercise – Vagal tone – Norepinephrine, epinephrine Cardiovascular Responses: Heart Rate During Exercise • Directly proportional to exercise intensity • Maximum HR (HRmax): highest HR achieved in all-out effort to volitional fatigue – – – – Highly reproducible Declines slightly with age Estimated HRmax = 220 – age in years Better estimated HRmax = 208 – (0.7 x age in years) Cardiovascular Responses: Heart Rate During Exercise • Steady-state HR: point of plateau, optimal HR for meeting circulatory demands at a given submaximal intensity – If intensity , so does steady-state HR – Adjustment to new intensity takes 2 to 3 min • Steady-state HR basis for simple exercise tests that estimate aerobic fitness and HRmax Cardiovascular Responses: Stroke Volume (SV) • With intensity up to 40 to 60% VO2max – Beyond this, SV plateaus to exhaustion – Possible exception: elite endurance athletes • SV during maximal exercise ≈ double standing SV • But, SV during maximal exercise only slightly higher than supine SV – Supine SV much higher versus standing – Supine EDV > standing EDV Cardiovascular Responses: Factors That Increase Stroke Volume • Preload: end-diastolic ventricular stretch – Stretch (i.e., EDV) contraction strength – Frank-Starling mechanism • Contractility: inherent ventricle property – Norepinephrine or epinephrine contractility – Independent of EDV ( ejection fraction instead) • Afterload: aortic resistance (R) Cardiovascular Responses: Stroke Volume Changes During Exercise • Preload at lower intensities SV – Venous return EDV preload – Muscle and respiratory pumps, venous reserves • Increase in HR filling time slight in EDV SV • Contractility at higher intensities SV • Afterload via vasodilation SV Ventricular Contractility Cardiovascular Responses: Blood Pressure • During endurance exercise, mean arterial pressure (MAP) increases – Systolic BP proportional to exercise intensity – Diastolic BP slight or slight (at max exercise) • MAP = Q x total peripheral resistance (TPR) – Q , TPR slightly – Muscle vasodilation versus sympatholysis Cardiovascular Responses: Blood Flow Redistribution • Cardiac output available blood flow • Must redirect blood flow to areas with greatest metabolic need (exercising muscle) • Sympathetic vasoconstriction shunts blood away from less-active regions – Splanchnic circulation (liver, pancreas, GI) – Kidneys Cardiovascular Responses: Blood Flow Redistribution • Local vasodilation permits additional blood flow in exercising muscle – Local VD triggered by metabolic, endothelial products – Sympathetic vasoconstriction in muscle offset by sympatholysis – Local VD > neural VC • As temperature rises, skin VD also occurs – Sympathetic VC, sympathetic VD – Permits heat loss through skin Blood Flow Redistribution Cardiovascular Responses: Cardiovascular Drift • Associated with core temperature and dehydration • SV drifts – Skin blood flow – Plasma volume (sweating) – Venous return/preload • HR drifts to • Compensate • (Q maintained) Cardiovascular Responses: Fick** Principle • Calculation of tissue O2 consumption depends on blood flow, O2 extraction • VO2 = Q x (a-v)O2 difference • VO2 = HR x SV x (a-v)O2 difference • VO2max = Qmax [(a-v)O2 diffmax] **ExPhysRules (who IS Fick?) Cardiovascular Responses: Blood Oxygen Content • (a-v)O2 difference (mL O2/100 mL blood) – Arterial O2 content – mixed venous O2 content – Resting: ~6 mL O2/100 mL blood – Max exercise: ~16 to 17 mL O2/100 mL blood • Mixed venous O2 ≥4 mL O2/100 mL blood – Venous O2 from active muscle ~0 mL – Venous O2 from inactive tissue > active muscle – Increases mixed venous O2 content VO2max • The highest amount of oxygen a person can take in, transport and utilize to produce AP aerobically while breathing air during heavy exercise. – – – – Blood lactate value > 8-9mmol/L HR + 12bpm of predicted MHR (220-age) Respiratory exchange ratio of 1.0-1.1 A plateau in oxygen consumption during incremental exercise (rise < 2.1ml/kg/min in VO2 with an increase in workload that represents a change in grade of 2.5% while running at 7mph with 3 min stages). VO2max • • • • THE measure of aerobic fitness Laboratory assessment Performance-based concept Possible limitations of VO2max: – Ventilation – Blood flow – Metabolic functions • Lactic acid • pH • ATP availability Respiratory Responses: Ventilation During Exercise • Immediate in ventilation – Begins before muscle contractions – Anticipatory response from central command • Gradual second phase of in ventilation – Driven by chemical changes in arterial blood – CO2, H+ sensed by chemoreceptors – Right atrial stretch receptors Respiratory Responses: Ventilation During Exercise • Ventilation increase proportional to metabolic needs of muscle – At low-exercise intensity, only tidal volume – At high-exercise intensity, rate also • Ventilation recovery after exercise delayed – Recovery takes several minutes – May be regulated by blood pH, PCO2, temperature Figure 8.14 Respiratory Responses: Estimating Lactate Threshold • Ventilatory threshold as surrogate measure? – Excess lactic acid + sodium bicarbonate – Result: excess sodium lactate, H2O, CO2 – Lactic acid, CO2 accumulate simultaneously • Refined to better estimate lactate threshold – Anaerobic threshold – Monitor both VE/VO2, VE/VCO2 Ventilatory Equivalents During Exercise Respiratory Responses: Limitations to Performance • Ventilation normally not limiting factor – Respiratory muscles account for 10% of VO2, 15% of Q during heavy exercise – Respiratory muscles very fatigue resistant • Airway resistance and gas diffusion normally not limiting factors at sea level • Restrictive or obstructive respiratory disorders can be limiting Respiratory Responses: Limitations to Performance • Exception: elite endurance-trained athletes exercising at high intensities – Ventilation may be limiting – Ventilation-perfusion mismatch – Exercise-induced arterial hypoxemia (EIAH) Respiratory Responses: Acid-Base Balance • Metabolic processes produce H+ pH • H+ + buffer H-buffer • At rest, body slightly alkaline – 7.1 to 7.4 – Higher pH = Alkalosis • During exercise, body slightly acidic – 6.6 to 6.9 – Lower pH = Acidosis Respiratory Responses: Acid-Base Balance • Physiological mechanisms to control pH – Chemical buffers: bicarbonate, phosphates, proteins, hemoglobin – Ventilation helps H+ bind to bicarbonate – Kidneys remove H+ from buffers, excrete H+ • Active recovery facilitates pH recovery – Passive recovery: 60 to 120 min – Active recovery: 30 to 60 min Figure 8.16 Sex differences in CV responses • FFM • Blood volume & Heart Size • O2 carrying capacity