Effetti Acuti Cardiovascolari ed Esercizio Effetti Acuti Cardiovascolari ed Esercizio FisicoFisico

1.1. Fase preparatoria Fase preparatoria iniziale iniziale Stimolazione adrenergica Stimolazione adrenergica Vasocostrizione distrettualeVasocostrizione distrettuale

2.2. Fase intermedia Fase intermedia metabolicametabolica Fattori locali Stimolazione Fattori locali Stimolazione adrenergicaadrenergica

Risposta Cardiovascolare Risposta Cardiovascolare all’Esercizio Acutoall’Esercizio Acuto

• Fase preparatoria Fase preparatoria inizialeiniziale

• Stimolazione adrenergica Stimolazione adrenergica (cuore) (cuore)

• vasocostrizione distrettualevasocostrizione distrettuale

Risposta Cardiovascolare Risposta Cardiovascolare all’Esercizio Acutoall’Esercizio Acuto

Fase preparatoria inizialeFase preparatoria iniziale Stimolazione adrenergica (cuore)Stimolazione adrenergica (cuore)

Risposta Cardiovascolare Risposta Cardiovascolare all’Esercizio Acutoall’Esercizio Acuto

Resting, anticipatory, and maximum exercise heart Resting, anticipatory, and maximum exercise heart rate in competitive runners and untrained subjects rate in competitive runners and untrained subjects

during all-out runningduring all-out running

EventEvent60 yards60 yards220 yards220 yards440 yards440 yards880 yards880 yards1 mile1 mile2 mile2 mile

RESTRESTT UTT UT6767 696967 6767 676363 63636464 70706565 646459 7459 74

ANTICIPANTICIPT UTT UT148148 124124149149 115115150150 118118151151 129129152152 128128108 109108 109

EXERCISEEXERCISET UTT UT177 177 162162191191 186186192192 189189193193 194194195195 198198206 199206 199

T = TrainedT = TrainedUT = UntrainedUT = Untrained

McArdle W.D. Telemetred cardiac response to selected running eventsMcArdle W.D. Telemetred cardiac response to selected running events J. Appl. Physiol. 23:566,1967J. Appl. Physiol. 23:566,1967

Integreted chemical,neural and hormonal Integreted chemical,neural and hormonal adjustaments prior to and during exerciseadjustaments prior to and during exercise

ActivatorActivator Activation of motor Activation of motor

cortex and higer cortex and higer areas of brain areas of brain causes increase in causes increase in sympathetic outflow sympathetic outflow and reciprocal and reciprocal inhibition of inhibition of parasympathetic parasympathetic activityactivity

ResponseResponse Acceleration of heart Acceleration of heart

rate; increased rate; increased myocardial contractility; myocardial contractility; vasodilatation in skeletal vasodilatation in skeletal and heart muscle and heart muscle (cholinergic fibres); (cholinergic fibres); vasoconstriction in vasoconstriction in other areas, especially other areas, especially in skin,gut,spleen, liver in skin,gut,spleen, liver and kidneys (adrenergic and kidneys (adrenergic fibres); increase in fibres); increase in arterial blood pressure.arterial blood pressure.

PreexercisePreexercise““anticipatory”anticipatory”responseresponse

Integreted chemical,neural and hormonal Integreted chemical,neural and hormonal adjustaments prior to and during exerciseadjustaments prior to and during exercise

Continued sympathetic Continued sympathetic cholinergig outflow; cholinergig outflow; alterations in local alterations in local metabolic conditions due metabolic conditions due to hypoxia, to hypoxia, pH, pH, CO2, CO2, ADP, ADP, Mg++, Mg++, Ca++, Ca++, temperature.temperature.

Continued sympathetic Continued sympathetic adrenergic outflow in adrenergic outflow in conjunction with conjunction with epineprhine and epineprhine and norepineprhine from the norepineprhine from the adrenal medullaadrenal medulla

Further dilatation of muscle Further dilatation of muscle

vasculaturevasculatureConcomitant constriction of Concomitant constriction of

vasculature in inactive tissues vasculature in inactive tissues to maintain adeguate to maintain adeguate perfusion pressure throu perfusion pressure throu ghout arterial system.ghout arterial system.

Venous vessels stiffen to reduce Venous vessels stiffen to reduce their capacity. This their capacity. This venoconstrinction facilitates venoconstrinction facilitates venous return and venous return and maintainsthe central blood maintainsthe central blood volumevolume

ConditionCondition

EXERCISEEXERCISE

ActivatorActivator ResponseResponse

Distribution of Flow at Rest and during Distribution of Flow at Rest and during Acute ExerciseAcute Exercise

20%

4%

6%

27%

22%

14%

7%

MuscleHeartSkinBrainOtherLiverKidneys

Muscle84%

4%

1%4%

CRMSCRMS

5%

RestRest3-5 Lmin3-5 Lmin

ExerciseExercise25-30 Lmin25-30 Lmin

Distribution of Flow at rest and during Distribution of Flow at rest and during Acute ExerciseAcute Exercise

Heart Rate in Response Heart Rate in Response to Exerciseto Exercise

50

70

90

110

130

150

170

190

210

0 50 100 150 200 250

Watts

HR

VO 2 max (l/min)

Age (years)

Max workload (W/min)

300

200

100100

200

300

Men r=-0.61

Women r=-0.57

3.0

2.0

1.0

20 40 60Men Women

Age-related decline in Maximal Oxygen Consumption and Maximal Workload

Cardiovascular Response to Cardiovascular Response to Acute Exercise ( Stroke Volume)Acute Exercise ( Stroke Volume)

Cardiovascular Response to Acute Cardiovascular Response to Acute Exercise (Cardiac Output)Exercise (Cardiac Output)

Cardiovascular Response to Cardiovascular Response to Acute ExerciseAcute Exercise

Cardiovascular Response to Exercise Cardiovascular Response to Exercise in Men and Womenin Men and Women

Age and End Diastolic Volume during Age and End Diastolic Volume during Acute ExerciseAcute Exercise

Change of Left Ventricular Ejection Change of Left Ventricular Ejection Fraction from Rest to ExerciseFraction from Rest to Exercise

Blood Pressure Blood Pressure ==

COCO x Peripheral Resistance x Peripheral Resistance

In normal subjects exercise In normal subjects exercise increases Cardiac Output and/or increases Cardiac Output and/or decreases Peripheral Resistancedecreases Peripheral Resistance

60

80

100

120

140

160

180

200

0 100 150 250

Exercise and Blood Pressure in Exercise and Blood Pressure in normal subjectsnormal subjects

Watts

P.A.

Exercise and Blood PressureExercise and Blood Pressure normal subjects normal subjects

Exercise and Blood PressureExercise and Blood Pressure normal subjects normal subjects

Men < 20

Men > 20

Systolic

Systolic

Diastolic

Diastolic

Coronary Flow and Heart RateCoronary Flow and Heart Rate

020406080

100120140160180200

0 100 125 150 175 200

HRHR

Cor.Flow

Cardiovascular Cardiovascular Response to ExerciseResponse to Exercise

0

20

40

60

80

100

120

140

160

180

200

50 100 150 200

WattsWatts

Coro

nary

Fl o

wC

oro

nar y

Flo

wC

c/ m

i n/ 1

00g

rC

c/m

i n/1

00g

r

0

20

40

60

80

100

120

140

160

180

200

3 5 10 20

Myocardial O2 CosumptionMyocardial O2 Cosumptioncc/min/100grcc/min/100gr

Effetti della Vasocostrizione sul Effetti della Vasocostrizione sul Flusso CoronaricoFlusso Coronarico

Exercise,Vasoconstriction Exercise,Vasoconstriction and Coronary Flowand Coronary Flow

VasoconstrictionVasoconstriction(Acute Exercise)(Acute Exercise)

25% Radius25% Radius63% Area63% Area

17% Radius17% Radius96% Area96% Area

Effetti della Vasocostrizione sul Effetti della Vasocostrizione sul Flusso CoronaricoFlusso Coronarico

H.R. b/min

Recovery

Cycloergometer

Cardiovascular Response to Cardiovascular Response to Acute Exercise in trained subjectsAcute Exercise in trained subjects

Cardiovascular Response to Acute Cardiovascular Response to Acute Exercise in trained subjectsExercise in trained subjects