Anatomy

Physiology
End Systolic Volume =
Amount of blood remaining
in the ventricles at the end of
the emptying period (systole)
Normal Value: 40-50 ml
End Diastolic Volume =
Amount of blood in the
ventricles after the filling
period (diastole)
Normal Value: 110-120 ml
 Physiology
• Oxygen extraction is nearly 65% at all levels of activity
• Most efficient at aerobic metabolism
• Carbohydrates are usually 40% of the metabolism, with fatty acids
making up most of the remaining 60% metabolism
 Physiology
• Total Oxygen Consumption (VO2) = Oxygen consumption of the whole
body
• Aerobic Capacity (VO2 Max) = Measure of the work capacity of an
individual
• Increases linearly with an increase in workload
• Expressed in mm of O2 consumed per kilogram of body weight per minute
(ml/kg/min)
• In exercise, VO2 max is increased
• Myocardial Oxygen Consumption/ Demand (MVO2) = Actual oxygen
consumption of the heart
 Physiology
• Metabolic Equivalent (MET) = Measure of the oxygen cost or
requirement for an activity
• Best index of physical work capacity
• 1 met = 3.5 ml of O2 consumed per kilogram of body weight per minute
Interactions of Intact Circulation
• Preload = Amount of tension in the
left ventricular muscles before
contraction
• Filling pressure of the left ventricle
• Also known as Left Ventricular End
Diastolic Volume (LVEDV)
• Afterload = Force that the left
ventricle must generate during
systole to overcome the aortic
pressure and open the aortic valve
• Peripheral vascular resistance
• Stroke Volume (SV) = Amount of blood
that is ejected with each myocardial
contraction
• Normal value 60-130ml
• Preload - Major determinant of SV
• Stroke volume increased at rest and all
levels of exercise
• During incremental exercise, SV increases
the most during early exercise

• Ejection Fraction (EF) = Stroke Volume/

LVEDV
• Widely used clinically as an index of
contractility/ measure of systolic LV function
• Normal Value: 55%-75%
• HR = beats per minute
• The physiologic regulation of HR is
mediated by the interaction of vagal
and sympathetic tone and cir- culating
catecholamines
• Linear increase in relation to VO2 or
other measures of work
• HR is lower at rest and any given
workload
• Cardiac Output (CO) = HR x SV
• Amount of blood that leaves the
ventricles every minute
• Normal value: 4-6L/min
• Increases linearly with work
• Primary determinant of VO2max and
declines with age without any change
in linearity or slope
• In exercise, maximum CO increases
• Peripheral Vascular Resistance (PVR)
= Influenced by arteriolar tone,
vasoconstriction and a blood
viscosity
• Increased during sympathetic
stimulation
• Peripheral vascular resistance
decreases in training
• Blood Pressure (BP) = Blood
Pressure (BP) = CO x PVR
• Influenced by HR, venous pressure, and
left ventricular contractility
• MVO2
• Determined directly with cardiac
catheterization
• estimated using the rate pressure
product (RPP)
• Double Product/ Rate Pressure Product
(RPP) = (SBP x HR)/100
• MVO2 rises in a linear fashion with
workload
• In any given workload, decreased with
training