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Cardiovascular Changes

During Exercise

PBL-3

28th March, 2016


Objectives

Outline the determinants of Myocardial oxygen


demand and supply
Describe the Cardiovascular changes during
exercise
Myocardial Oxygen Demand

Directly related to amount of tension developed by


ventricles
During exercise the cardiac output is increased 4 to 5 times
in normal individual whereas increases 6 to 7 times in
trained athlete
It is determined by:
Heart rate
Preload
Afterload
Contractility
Heart Rate

High Heart Rate:


More oxygen consumed at the tissue level
Less oxygen rich blood delivered at the tissue
level (less time for ventricular filling)
Preload

Degree of Ventricular stretch at end Diastole


Determined by the volume of blood in the ventricle at end
diastole
With increased Preload
in ventricular wall stress

in myocardial oxygen consumption


Afterload

The load against which the heart must


contract to eject blood into the aorta
When afterload is high
in ventricular wall stress
in myocardial oxygen consumption
Contractility

Strength of myocardial muscle fiber shortening


during systole
Influenced by preload
Greater muscle fiber stretch Greater recoil

When contractility is high

in wall stress
in myocardial oxygen consumption
Myocardial Oxygen Supply

Coronary Artery Anatomy


Diastolic Pressure
Diastolic Time
Oxygen Extraction
Hemoglobin

PaO2
Coronary Artery Anatomy
Diastolic Pressure and Time

The myocardium receives its blood during diastole


Diastolic pressure Blood Flow

Diastolic pressure Blood Flow

Diastolic time determines the time of coronary


blood filling
Diastolic time Blood Flow
Diastolic time Blood Flow
Fast heart rate means less time for coronary blood
filling
Oxygen Extraction

Oxygen is transported through blood in two


ways
Combined with hemoglobin
Dissolved in blood
Cardiovascular changes during exercise
References

Guyton and Hall textbook of medical physiology,


12th edition
Linda S. Costanzo, Physiology, 5th edition
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