Cardiovascular System

Cardiovascular Regulation
Cardiovascular Dynamics during Exercise
McArdle, Katch and Katch, 3rd ed.
 Cardiovascular Regulation

• Heart Rate Regulation

• Blood Flow Regulation
 Intrinsic Regulation of HR
• Sino atrial node: pacemaker
 Depolarization and
Repolarization
• Depolarization creates an action potential or
electrical impulse
• Impulse travels across the heart in an
established pathway
• SA node →across atria →AV node →AV
bundle →left & right bundle branches →
Purkinjie fibers → Ventricles
 Intrinsic Heart Rate
• Approximately 90 bpm
• Parasympathetic innervation slows rate
• referred to as parasympathetic tone
• training increases parasympathetic tone
 Electrodes Monitor Electrical
Conduction
• ECG - electrocardiogram
• picture of electrical events
• established electrode pattern results in
specific tracing pattern
• health of heart may be examined using ECG
• electrical pattern reveals blood supply
problems
 Standard ECG Tracing
• P wave - atrial depolarization
• QRS complex - ventricular depolarization
• masks atrial repolarization
• T wave - ventricular repolarization
 Extrinsic Regulation of HR
• Neural
• Sympathetic: catecholamines
• Epinephrine

• Norepinephrine

• Parasympathetic
• Acetylcholine

• Cortical
• Peripheral
 Neural Regulation
• Sympathetic influence
• Epinephrine  ↑HR
(tachycardia) and ↑
contractility
• Norepinephrine 
general vasoconstrictor
• Parasympathetic influence
acetylcholine→↓HR
(bradycardia)
 Cardiac Accelerator Nerves
• Innervate SA node & ventricles
• Increase heart rate
• Increase contractility
• Increase pressure
 Vagus Nerve
• Innervates SA node & AV node
• Releases acetylcholine
• Slows heart rate
• Lowers pressure
 Cortical and Peripheral
Influences
• Cerebral cortex
impulses pass through
medulla oblongata.
• Peripheral input
• Mechanoreceptors
• Baroreceptors
• Chemoreceptors
Baroreceptors
• Baroreceptors in
carotid sinus and
aortic arch.
• ↑ pressure → ? HR
& contractility
• ↓ pressure → ? HR
& contractility
 Blood Distribution
• During exercise, local
arterioles dilate and
venous capacitance
vessels constrict.
• Blood flow is regulated
according to Poiseuille’s
Law: Flow = pressure 
resistance.
 Blood Flow
• Flow = pressure gradient x vessel radius4
vessel length x viscosity
• Local factors
• ↓ tissue O2 produces potent vasodilation
in skeletal and cardiac muscle
• ↑ temp, ↑ CO2, ↓ pH, ↑ ADP, ↑ Mg+ →
increased blood flow local tissue
 Factors Resulting in Dilation
• Increased temperature
• Elevated CO2
• Lowered pH
• Adenosine
• Nitric Oxide
• Ions of Mg2 and K+
• Acetylcholine
 Capillary Recruitment
• 1 of every 30 or 40 capillaries is open in
muscle at rest
• Capillaries are perfused during exercise
• Increases blood flow to muscle
• Reduces speed of blood flow
• Increases surface area for gas exchange
 Blood Flow
• Sympathetic (adrenergic): norepinephrine
general vasoconstrictor
• Sympathetic (cholingergic): acetylcholine
vasodilation in skeletal and cardiac muscle.
Integrated Response
 Heart Depends Upon Aerobic
Metabolism
• Must increase flow 4 to 6 times during
exercise
• coronary vessels dilate
• pressure increases
 Heart Work Estimate
• HR X SBP = Double product
• also called rate pressure product
 Cardiovascular Dynamics during
Exercise
Cardiac Output (Q): amount of blood pumped
per minute.
• Q = Heart Rate x Stroke Volume. Fick
Equation.
• Cardiac Output = 5 L/min trained & untrained
• Untrained = 70 bpm x 71 ml = 5000 ml
• Trained = 50 bpm x 100 ml = 5000 ml
• Larger stroke volumes after training.
Exercise Cardiac Output
• Blood flow from heart
increases in direct
proportion to exercise
intensity.
• Increases @ higher
intensity mainly due to
increases in heart rate.
 Increased Cardiac Output
• Venous return must increase
• Venoconstriction - reduces capacity to hold
large volume of blood
• Muscle pump - active muscles squeeze
veins forcing blood back towards heart
• Respiratory pump - inspiration lowers
thoracic pressure
 Stroke Volume
Stroke Volume: amount
of blood pumped each
cardiac cycle.
• Increased diastolic
filling before systole
occurs through any
factor that increases
venous return
(preload).
 Stroke Volume Regulation
• End diastolic volume (EDV)
• fuller ventricle = greater stroke volume
• Frank Starling mechanism
• Afterload - pressure required to open the aortic
semilunar valve
• decreases during exercise due to vasodilation
• Catecholamines
• increase contractility via increased Ca 2+
 Increasing Cardiac Output
During Exercise
• SV increases due to increased EDV, greater
contractility & decreased afterload
• untrained individuals SV levels off
around 40% of VO2max
• well trained endurance athletes SV rises
to maximal levels
• Heart rate increases
Exercise Heart Rate
• Heart rate and VO2 are
linearly related in
trained and untrained
throughout major
portion of exercise
range.
• Endurance training
reduces HR at any
given submaximal
workload due to ↑ SV.
 Heart Rate and Oxygen
Consumption
• In healthy individuals, heart rate increases
linearly with exercise load or oxygen
uptake and plateaus just before maximal
oxygen consumption.
• If exercise load is held constant, below
lactate threshold, steady state is reached in
about 2 - 3 minutes.
 Transition from Rest to
Exercise
• Rapid increase in heart rate, SV, cardiac output
• due to withdrawal of parasympathetic stimuli
• increased input from sympathetic nerves
• Continued increase in heart rate
• temperature increases
• feedback from proprioceptors
• accumulation of metabolites
 Blood Flow During Exercise
• Redistributed
• Muscle arterioles dilate
• Increased perfusion of muscle capillaries
• Vasoconstriction within nonactive tissue
• Venoconstriction increases blood on arterial
side of system
 Distribution during Exercise
• Blood flow to specific
tissue directly related
to metabolic activity.
• Blood flow to skin
increases during light
and moderate exercise
but during intense
exercise blood shunted
to muscles.
 Oxygen Extraction
• Increased arterio-
venous oxygen
extraction with
increased work
intensity
• Fick Equation:

VO2 max = Q x av O2
difference
 Increasing Oxygen
Consumption During Exercise
• O2 extraction depends upon O2 content of blood &
removal rate by tissues
• O2 removal depends upon
• capillary density
• myoglobin content
• mitochondria number
• oxidative capacity of mitochondria
• muscle fiber type
• PO2 gradient from capillaries to tissue
 Calculation of Oxygen
Consumption
• Direct measurement - open circuit
spirometry
• Indirect - Fick Principle
• consumption = cardiac output x
extraction
• arterial - venous O2 = extraction
Oxygen Consumption Factors
• Cardiac output
• maximal heart rate
• maximal stroke volume
• training increases stroke volume, does not
influence max HR
• Extraction by tissues
• training increases capillary and mitochondria
number
 Maximal Oxygen
Consumption
(VO2max)
• Partially determined by genetic makeup
• Influenced by training state
• Limits performance
• Expressed as ml O2 . kg -1 . min -1
 Cardiovascular Drift
• Prolonged exercise due to dehydration
• Warm environment
• Reduction in blood volume
• Decreased stroke volume
• Heart rate rises to maintain required cardiac
output.