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Left Main CA
Adventitia
Media
Intima
Right CA
contractility
SV
normal
contractility
left
ventricular
contractility
performance
(heart failure)
dP/dt dP/dt
Normal
120
Heart Failure
Note elevation in
end diastolic
pressure
0
Contractility
- a change in developed tension at a given
resting fiber length OR an increase in Vmax
increase max dP/dt from LV pressure curve
Positive and negative inotropic effects
Ejection fraction (EF = SV/EDV) used in clinical
practice
increase contractility assumed with increase EF
with Ca, NE, digitalis, exercise; with [K]o,
[Na]o
Influences on Myocardial Contractility
Contractility related to :
beta-sympathetic adrenergic nerves
catecholamines: epinephrine
norepinephrine
drugs: digitalis
sympathomimetics
Precapillary
Sphincters
Liver
Stomach
Pancreas
Intestines
Kidneys
Arterioles
Skin
Muscle
Microcirculatory Anatomy
Precapillary
Sphincter
Anastomosis
(Shunt)
True Capillary
With Single
Layer of
Endothelium
Metarteriole
Venule
Effects of an Increase in Preload on
Left Ventricular Pressure Volume Loop
Ejection Pressure
Left 120
Ventricular
Pressure
SV
(mmHg)
EDV
EDP
6
40 140
Volume
(ml)
Effects of an Increase in Afterload on Left
Ventricular Pressure Volume Loop
ESV
ESP
Left 120
Ventricular
Pressure
SV
(mmHg)
40 140
Volume
(ml)
Mechanism of Control of
Cardiovascular and
Respiratory Systems
Sites of
Cardiorespiratory
Control
Cardiorespiratory Control
120
Stroke 110
Volume
70
(ml/beat
25% 50% 75%
Percentage of VO2 max
Arteriovenous oxygen difference
Difference in [O2] between arterial and mixed venous blood
Illustrated by the oxyhemoglobin desaturation curve
approximately 3 fold from rest to max exercise
at rest, about 25% of arterial O2 is extracted
at peak exercise 85% of arterial O2 is extracted Acute Responses
to Aerobic
Blood Pressures and Resistance to Flow Exercise
SBP: - failure to signifies heart failure
DBP: slight or slight or NC
MAP: slight
TPR: - mainly due to vasodilation in exercising muscle
Minute Ventilation
resting average: 6 Liters/min
peak exercise average: 175 Liters/min
respiratory rate: resting 12-18 peak exercise: 45-60
tidal volume: resting .5 liters peak exercise: 2.25 Liters
Plasma Volume
blood plasma in the interstitum of exercising muscle
fluid shift results in a 5% in the hemoconcentration
blood viscosity increases
Oxygen
Oxygen Debt
DEBT and Deficit
& Oxygen DEFICIT
P AC O 2 & P aC O 2
No Change in
VE
Ventilatory and V E
Metabolic VCO2
Changes
During VCO 2
VO 2 m ax
Exercise
VO 2
-
HCO 3
pH
Increasing
workload
Training Adaptations to
Chronic Endurance
Exercise
Resting
NC NC
VO2 = HR x SV x AVO 2diff
Heart Rate
( beats / minute )
150
100 75
60
50
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
Stroke Volume
( ml / beat )
160
150 120
100 80
60
50
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
Cardiac Output
( liters / minute)
40
35 30
30
22
25
20
15
10 5 5
5
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
A-V O2 Difference
( ml%)
20
16
14
15
10
6 6
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
Oxygen Consumption
( liters / minute)
6
4.5
5
4 3
3
2
1 0.25 0.25
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
Oxygen Consumption
( ml / kg / minute)
55
60
50
38
40
30
20
10 3.5 3.5
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
210 206
200
134 130
150
100
50
0
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
90
88
86 84
84 82 82
82 80
80
78
76
74
sedentary-rest sedentary-max trained-rest trained-max
"Average" Values for Sedentary and
Trained Individuals
Minute Ventilation
( liters / minute)
150
160
140 120
120
100
80
60
40
6 6
20
0
sedentary-rest sedentary-max trained-rest trained-max