Cardiovascular Control During Exercise

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Structure & Function of CV

Major CV functions fall into 5 categories: 1. Delivery O2 & nutrients 2. Removal CO2 & metabolic waste 3. Transport hormones to receptors 4. Maintenance body temperature, blood
buffering capacity

5. Prevention dehydration, infection

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Structure & Function of CV

The circulatory system has 3 components: A pump (heart) A system channel (blood vessels) A fluid medium (blood)

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The Heart
Has 2 atria acting as receiving chambers & 2 ventricles acting as sending units

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Blood Flow through the Heart

Blood delivering O2, nutrient & picking up waste products, return to the great vein (super & inferior vena cava) to the right atrium This chamber received all the body deoxygenated blood. From the right atrium, blood passes through the tricuspid valve into the right ventricles. This chamber pumps the blood through the pulmonary semilunar valve into the pulmonary artery, which carries the blood to the right & left lungs. Thus, the right side of the heart is known as the pulmonary side, sending the blood that has circulated throughout the body into the lungs for reoxygenation
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Blood Flow through the Heart

After receiving a fresh supply of O2, the blood exits the lungs through the pulmonary veins, which carry it back to the heart & into the left atrium From the left atrium, the the freshly oxygenated blood passes through the bicuspid (mitral) valve into the left atrium Blood leaves the left ventricle by passing through the aortic semilunar valve into the aorta, which sends it out to all body parts & systems The left side of the heart is known as the systemic side.

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The Myocardium
Cardiac muscle is collectively called the myocardium Myocardial thickness varies directly with the stress placed on the heart chambers wall. The left ventricles is the most powerful of the 4 heart chambers Through it contractions, this chamber must pump blood through the entire systemic route. When sitting or standing, the left ventricle must contract enough force to overcome the effect of gravity, which tends to pool blood in the lower extremities

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Cardiac Conduction System

Cardiac muscle has a unique ability to generate its own electrical signal call autoconduction. 4 components:
Sinoatrial (SA) note Atrioventricular (AV) node Atrioventricular (AV) bundle (Bundle of His) Purkinje fibers
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Extrinsic Control of Heart Activity

Parasympathetic nervous system (PNS) Sympathetic nervous system (SNS) Endocrine system (hormones)

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Extrinsic Control of Heart Activity

PNS
Slow impulse conduction Decrease HR

SNS
Increase impulse conduction Increase HR

Endocrine system
Release catecholamines (norepinephrine & epinephrine) Increase HR
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Cardiac Arrhythmias
2 types: Bradycardia
Slow heart RHR < 60bpm

Tachycardia
Fast heart RHR > 100bpm

Symptoms of both arrhythmias include fatigue, dizziness, lightheadedness and fainting, Tachycardia can cause palpitations (Palpitations
are the awareness that your heart is beating forcefully, rapidly, or irregularly) SPS211/FSRUiTM

The ECG
3 components of ECG represent aspects of cardiac function:
1. P wave 2. QRS complex 3. T wave

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ECG
P wave
Atrial depolarization Electrical impulse travel from SA node to AV node

QRS complex
Ventricular depolarization Occurs as impulse spread from AV bundle to Purkinje fibers

T wave
Ventricular repolarization
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Terminology of Cardiac Function

Cardiac Cycle
Relaxation phase (diastole)
The chamber is full with blood Phase longer than the systolic phase

Contraction phase (systole)

The chamber contract & expel their content

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Terminology of Cardiac Function

Atrial BP
Measured by sphygmomanometer Normal BP 120/80
Adult female 110/70 Larger no systolic pressure (mm Hg) Lower no diastolic pressure (mm Hg)

SBP pressure generates as the blood ejected from the heart during ventricular systole DBP during ventricular relaxation (diastole), the atrial BP decreases

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Terminology of Cardiac Function

Stroke Volume (SV)
During systole, a certain amount of blood is ejected from the left ventricle. This amount is the SV of the heart or volume of blood pumped per stroke EDV at the end of diastole, just before the contraction ESV the volume of blood remaining in the ventricle after ejection phase

SV = EDV - ESV
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Terminology of Cardiac Function

Calculate the stroke volume in milliliters if heart rate equals 130bpm and cardiac output equals 10 L. min-1.
SV = = Q / HR 10 / 130

0.077 L or 77 ml

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Terminology of Cardiac Function

Ejection Fraction
The proportional of the blood pumped out of the left ventricle is the EF at each beat EF = SV EDV

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Terminology of Cardiac Function

Cardiac Output (Q)
Total volume of blood pumped by the ventricle per minute or simply the product of HR and SV Q = HR x SV

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The Blood
Functions:
Transportation Temperature Regulation Acid-base (pH) balance

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Blood Volume
Total blood volume in the body varies considerably. Larger BV is associated with :
Larger body size High level of endurance training

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Blood Composition
Blood is composed of:
55% plasma
90% H2O 7% plasma protein 3% cellular nutrients, electrolytes, enzymes, hormones, antibodies and waste

45% formed elements

>99% RBC (erythrocytes) <1% WBC (leukocytes) and platelets (thrombocytes)

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Blood Composition
WBC
Protect the body from disease organism invasion via:
Directly destroying invading agents through phagocytosis (ingestion) Forming antibodies to destroy them

Platelets
Required for blood coagulation (clotting), which prevent excessive blood loss
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Blood Composition
RBC
Adequate oxygen delivery to body tissues depends on having a sufficient number of carriers (RBC) RBC transport oxygen primarily bound to their hemoglobin. Hemoglobin is composed of a protein (globin) and a pigment (heme) Heme contains iron, which binds oxygen.
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CV Response to Exercise
Heart Rate Stroke Volume Cardiac Output Blood Flow Blood Pressure The Blood

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CV Response to Exercise
HR
RHR averages 60 to 80bpm Endurance trained athletes 28 to 40bpm. HR during exercise increases directly as exercise intensity increases. HR increases during exercise because of :
Neural
PNS reduced, SNS increased during exercise

Hormonal
Catecholamines secreted during exercise
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CV Response to Exercise
SV
SV is determined by:
Ventricle filing capacity
The volume of venous blood return ed to the heart Ventricular distensibility, or the capacity to enlarge the ventricle

Ventricle ability to empty

Ventricular contractility Aortic or pulmonary pressure (the pressure against which the ventricles must contract)

During exercise SV increases above resting values. However, it will plateau during steady state exercise.
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CV Response to Exercise
Why increased in SV? Frank-Starling Law
EDV Stretch myocardial fibres Contractile force Volume ejected
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CV Response to Exercise
Q
Increased in HR & SV - increased Q During exercise, Q increases primarily to match the need for increased oxygen supply to the working muscles Thus, more blood is forced out of the heart during exercise than when at rest, and circulation speeds up. This ensures that
adequate supply of O2 & nutrients reach the tissues Waste product are quickly cleared away

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CV Response to Exercise
BF
Redistribution of blood during exercise
Resting Q 15-20% goes to the muscle (BF to the kidney, liver, stomach and intestines) During exercise, muscle received 80-85% of Q As body start to overheat, more blood is directed to the skin to conduct heat away

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CV Response to Exercise
Cardiovascular Drift
With prolonged exercise or exercise in heat, BV is reduced by Loss of water via sweating Shifting of fluid out of the blood into the tissue (edema) With the total BV decreasing, with a redistribution of more blood to the periphery for cooling, cardiac filling pressure is reduced This causes decreased venous return to the right side of the heart. In turn this reduce in SV (EDV is decreased; SV = EDV ESV) The HR compensates for the decreased SV by increasing, in an effort to maintain Q

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CV Responses to Prolonged Exercise (at a constant work rate)

CV Drift

HR Q SV

15

30

45

60

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75 Exercise Time (min)

CV Response to Exercise
BP
Endurance type, whole body activity:
SBP increases in direct proportion to increased exercise intensity
SBP 120mmHg at rest can exceed 200-250mmHg at exhaustion
Increased SBP results from increased Q

DBP changes little

DBP reflects the pressure in the arteries when the heart is at rest. None of the changes alter this pressure significantly. Increased in DBP of 15mmHg or more are considered abnormal responses to exercise and are one of several indicators for immediately stopping a diagnostic exercise test.

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CV Response to Exercise
Resistance exercise
High intensity BP can exceed 480/350mmHg Lower body exercise BP higher
Due to smaller muscle mass in the UB compared to LB

Static resistance training (isometric) increased BP compare to dynamic exercise (isotonic)

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CV Response to Exercise
The Blood
Oxygen Content
At rest, blood oxygen content varies from 20ml of O2 per 100 ml of arterial blood to 14 ml of O2 of venous blood. The difference between these two values is the arterialvenous O2 difference (a-vO2 diff) (20ml 14ml = 6 ml) This value represents the extent to which O2 is extracted from the blood as it passes through the body With increasing rates of exercise, the a-vO2 diff increases progressively
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CV Response to Exercise
Plasma Volume
With the onset of exercise, there is an almost immediate increase in the loss of plasma volume A 10 to 20% or greater reduction in plasma volume can occur in prolonged work. Resistance training 7.7-13.9% loses If exercise intensity or environmental condition can cause sweating, additional plasma loss can be expected Reduction of plasma volume will impair performance Reduce in plasma volume also results in increased blood viscosity, which can impede blood flow and thus limit O2 transport
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CV Response to Exercise
Hemoconcentration
When plasma volume is reduced, hemoconcentration occurs. This mean that the fluid portion of the blood is reduced, and the cellular and protein portions represent the larger fraction of the total blood volume (more concentrated in the blood) Although the actual number of RBC might not increase, the net effect of this process is ti increase the number of RBC per unit of blood, which increases O2 carrying capacity

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CV Response to Exercise
Blood pH
Blood pH can change significantly during exercise, becoming more acidic as it moves from the slightly alkaline resting value of 7.4 to 7.0 of lower. The muscle pH decreases even further (< 6.5) The decrease in pH is primarily results from increased blood lactate accumulations during increased exercise intensity

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VO2max
VO2 max is the maximal capacity or the highest rate of O2 consumption by the body during maximal or exhaustive exercise. The rate of O2 consumption during max exercise is determines by
the cardiac output (SV x HR) and the arterial-venous oxygen difference (a-vO2 diff). Q tells how much oxygen-carrying blood leaves the heart in 1 min & a-vO2 diff indicates how much O2 is extracted from the blood by the tissues.

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