cardiovascular response to exercise the heart. outline general cardiac responses to exercise –...
TRANSCRIPT
![Page 1: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/1.jpg)
Cardiovascular response to exercise
The Heart
![Page 2: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/2.jpg)
Outline
• General cardiac responses to exercise– Control of heart rate– Control of stroke volume– Blood pressure– Distribution of blood flow– Barroreceptors
• Adaptations to training• Impact of the environment
![Page 3: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/3.jpg)
![Page 4: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/4.jpg)
![Page 5: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/5.jpg)
![Page 6: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/6.jpg)
Examples of work (METS)
• Rest 1• Cycling <10 mph 6• Cycling >20 mph 16• Running (10 min/mile) 10• Running (6 min/mile) 16
METS=metabolic equivalent tasks1 MET=resting energy expenditure= 3.5 mlO2kg-1 min-1= 1 Kcalkg-1 min-1
![Page 7: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/7.jpg)
O2
aO2 content=20 ml O2/100 ml blood
vO2 content=15 ml O2/100 ml blood
CO=5 L/min
![Page 8: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/8.jpg)
![Page 9: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/9.jpg)
Effects of Exercise on Blood Pressure
MABP-RAP = CO TPR
![Page 10: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/10.jpg)
80
120
Pressure(mmHg)
systolic
diastolic
mean
![Page 11: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/11.jpg)
![Page 12: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/12.jpg)
Impact of Dynamic and Isometric Exercise on Arterial Blood Pressure
Time (sec)
0 20 40 60 80 100 120 140
Blo
od
Pre
ssu
re (
mm
Hg
)
0
50
100
150
200
250
SystolicDiastolic
Work (W)
0 50 100 150 200 250
Blo
od
Pre
ss
ure
(m
mH
g)
0
50
100
150
200
250
SystolicDiastolic
Dynamic Static (isometric)
![Page 13: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/13.jpg)
Comparison of BP Response Between
Arm and Leg Ergometry
![Page 14: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/14.jpg)
Why is blood pressure going up? I thought we had sensors that control blood pressure.
![Page 15: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/15.jpg)
Arterial Baroreceptors
Cardiovascular Physiology. Berne and Levy 1972
![Page 16: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/16.jpg)
![Page 17: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/17.jpg)
Activation of Barroreceptor reflex
Response to an increase in arterial pressure• Withdrawal of sympathetic tone• Activation of parasympathetic tone• Results:
– Decrease heart rate and contractility– Arterial vasodilation– Increase in venous compliance
![Page 18: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/18.jpg)
Afferent nerve firing responds to absolute pressure and rate of change in pressure
![Page 19: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/19.jpg)
Baroreceptors adapt
0 100 2000
25
50
75
100
(im
pu
lses
/sec
)
FIR
ING
RA
TE
CA
RO
TID
NE
RV
E
ARTERIAL PRESSURE (mmHg)
LONG TERM
ACUTE
![Page 20: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/20.jpg)
Afferent and efferent neural baroreflex responses
Arterial Baroreflex Control of the Peripheral Vasculature in Humans: Rest and Exercise.FADEL, PAUL Medicine & Science in Sports & Exercise. 40(12):2055-2062, December 2008
![Page 21: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/21.jpg)
Afferent and efferent neural baroreflex responses to the application of neck pressure (NP) and neck suction (NS)
Arterial Baroreflex Control of the Peripheral Vasculature in Humans: Rest and Exercise.FADEL, PAUL Medicine & Science in Sports & Exercise. 40(12):2055-2062, December 2008
![Page 22: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/22.jpg)
3Heart rate control during exercise by baroreceptors and skeletal muscle afferents.OLEARY, DONAL Medicine & Science in Sports & Exercise. 28(2):210-217, February 1996.
Schematic illustration of the effect of exercise on arterial baroreflex control of heart rate. Exercise resets the relationship between arterial pressure and heart rate upward and to the right (OP = hypothetical arterial baroreflex operating point).
![Page 23: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/23.jpg)
Oxygen Demand
![Page 24: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/24.jpg)
O2
aO2 content=20 ml O2/100 ml blood
vO2 content=15 ml O2/100 ml blood
CO=5 L/min
![Page 25: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/25.jpg)
Meeting oxygen needs during exercise
Fick equation VO2 = Q (CaO2 – CvO2)
VO2 = [HR SV] (CaO2 – CvO2)
VO2 = [BP TPR] (CaO2 – CvO2)
![Page 26: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/26.jpg)
Oxygen Extraction (E)
CaO2 – CvO2
CaO2
Fick equation VO2 = Q (CaO2 – CvO2)
VO2 = Q CaO2 x E
E=
![Page 27: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/27.jpg)
Arterial and venous oxygen during exercise
O2Extraction=(19-12)/19=0.33
O2 Extraction=(19.5-2)/19.5=0.90
![Page 28: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/28.jpg)
Heart rate and stroke volume
![Page 29: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/29.jpg)
(% Vo2 max)
20 30 40 50 60 70 80 90 100
Heart rate (bpm)
60
80
100
120
140
160
180
200
![Page 30: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/30.jpg)
(% Vo2 max)
0 20 40 60 80 100
Stroke volume (ml/beat)
60
80
100
120
140
![Page 31: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/31.jpg)
(% Vo2 max)
0 20 40 60 80 100
Cardiac Output(liters/min)
4
6
8
10
12
14
16
18
20
22
![Page 32: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/32.jpg)
Heart rate
Estimate Maximal heart rate=208-0.7 x (age year)
=208-0.7x54=170 bpm
![Page 33: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/33.jpg)
Autonomic Nervous SystemNerves Neurotra
nsmitterDistribution
Effect
SNS CervicalThoracic
Pregang:ACHPostgang:NE
Heart,Arteries &Most veins
1(HR)
12
PNS Vagus and lumbar
Pregang:ACHPost gangACH
HeartVessels ofGenitalia & colon
HR
![Page 34: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/34.jpg)
Heart rate(bpm)
40
50
60
70
80
90
100
110
120
Atropine Atropine
Propranolol
Propranolol
The heart is under net vagal tone
![Page 35: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/35.jpg)
Epinephrine
• Source: Adrenal medulla
• Increase heart rate and contractility (1),
• low concentrations vasodilation (2)
• high concentrations vasoconstriction (1), decrease
venous compliance (1)
![Page 36: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/36.jpg)
Norepinephrine
• Source: Adrenal medulla
• Increase heart rate and contractility (1),
• Limited effect on 2
• At all concentrations vasoconstriction (1), decrease
venous compliance (1)
![Page 37: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/37.jpg)
Determinants of Cardiac Output
• Heart rate• Stroke volume
– Ventricular end-diastolic volume– Contractility– Afterload (aortic pressure)
![Page 38: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/38.jpg)
![Page 39: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/39.jpg)
![Page 40: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/40.jpg)
Venus Blood Return to Heart
• muscle pump• one-way venous valves • breathing
Return of blood to heart
![Page 41: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/41.jpg)
Increase Preload
![Page 42: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/42.jpg)
Increase Afterload
![Page 43: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/43.jpg)
Increase Contractility
![Page 44: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/44.jpg)
Stroke volume
• End diastolic volume– End-diastolic volume (Starling’s Law)
• End systolic volume– Afterload– Contractility
![Page 45: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/45.jpg)
Time between beats
![Page 46: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/46.jpg)
2Heart rate control during exercise by baroreceptors and skeletal muscle afferents.OLEARY, DONAL Medicine & Science in Sports & Exercise. 28(2):210-217, February 1996.
Increase in heart rate decreases filling time
Time b
etwee
n bea
ts
![Page 47: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/47.jpg)
What would happen if you could not increase adrenergic tone to the heart during exercise?
Metaprolol= 1 antagonist
![Page 48: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/48.jpg)
J Appl Physiol 106: 486-493, 2009
Ο average-trained
endurance trained
![Page 49: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/49.jpg)
Training and the CV system
VO2 = Q CaO2 x E
= SV x HR x CaO2 x E
![Page 50: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/50.jpg)
Training
Benefits seen after 3x week for 6 weeks• 70% of max heart rate
> 30 min/bout
• Maintenance 2x week but maintain intensity
![Page 51: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/51.jpg)
College Students World Class Athletes
Control Bedrest Trained
VO2 max (L/min) 3.3 2.4 3.9 5.3
Max Ventilation (L/min)
191 201 197 219
Arterial O2 (mlO2/100 ml blood)
21.9 20.5 20.8 22.4
Art-Ven O2 (mlO2/100 ml blood)
16.2 16.5 17.1 18
Max. cardiac Output (L/min)
20 14.8 22.8 30.4
Max Heart rate (bpm)
192 197 190 182
Stroke Volume (ml)
104 74 120 167
![Page 52: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/52.jpg)
Directly measured cardiac pressure–volume curves for athletes and non-athletic controls Note the marked improvement in both static and dynamic compliance in the endurance
athletes
Levine B D J Physiol 2008;586:25-34
![Page 53: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/53.jpg)
Winder et al JAP 45:370,1978
![Page 54: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/54.jpg)
Heart Adaptations to Training
Endurance trained Sedentary
Resistance trained
![Page 55: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/55.jpg)
1995 Marathon Training Data (females)
VO2 Pre-training Post-training 5 mph 30.7 29.8 6 mph 35.5 34.6
RER 5 mph 0.92 0.88* 6 mph 0.95 0.92*
HR 5 mph 168 151* 6 mph 182 167*
VO2max 54.4 58.5* HRmax 206 198*
*P < 0.05
![Page 56: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/56.jpg)
Adaptations to Training
Resting bradycardia• Increased stroke volume• Increased cardiac size and compliance
Increased blood volume• Lower vascular resistance at any work load• Improved flow distribution• Improved oxygen extraction• Improved heat tolerance
![Page 57: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/57.jpg)
Training Heart Rates
• Low range– Between 60-70% of maximal heart rate– ~50-60% of VO2 max
• High range– 90% of max heart rate– 85-90% of VO2max
![Page 58: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/58.jpg)
Thermal stress and exercise
![Page 59: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/59.jpg)
Duration of exercise ( min)
0 20 40 60 80 100
60
80
100
120
140
160
180
heart rate (BPM)
Stroke Volume (ml/beat)
cardiac output (%)
Impact of duration of exercise
![Page 60: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/60.jpg)
Rowell LR Ann Rev Physiol 54:75,1976
![Page 61: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/61.jpg)
Rowell LR. Ann Rev Physiol 54:75,1976
![Page 62: Cardiovascular response to exercise The Heart. Outline General cardiac responses to exercise – Control of heart rate – Control of stroke volume – Blood](https://reader030.vdocuments.mx/reader030/viewer/2022032705/56649db05503460f94a9eea2/html5/thumbnails/62.jpg)
Rowell LR. Ann Rev Physiol 54:75,1976