Chapter 16
Cardiovascular Regulation and
Integration
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Intrinsic Regulation of
Heart Rate
• Cardiac muscle has an inherent rhythm.
• The sinoatrial node
– Would generate a rate ~ 100 BPM
– Described as pacemaker
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Heart’s Electrical Activity
• Electrochemical rhythms spread from SA
node across atria to atrioventricular (AV)
node.
• AV node causes a slight delay of ~ 0.1 s.
– Allows ventricles to fill
• AV bundle (bundle of His)
– Right and left bundle branches
– Purkinje system
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Electrocardiogram (ECG)
• A recording of the heart’s electrical activity
• A standard system of lead placement has
established known wave patterns.
– P wave
– QRS complex
– T wave
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Extrinsic Regulation of Heart
Rate and Circulation
• Chemical: circulate via blood
• Neural: direct innervation
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Nutrition, and Human Performance, Sixth Edition
Sympathetic and Parasympathetic
Neural Input
• Operate in parallel
• Different structure pathways and
transmitters
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Sympathetic Influence
• Catecholamines
– Chronotropic: increases rate
– Inotropic: decreases rate
• Adrenergic fibers
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Parasympathetic Influence
• Vagus nerves: cholinergic fibers
– Release ACh
– Slow HR
• As exercise begins, there is a decrease in
parasympathetic activity.
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Input from Higher Centers
• Central command: coordinates neural
activity to regulate flow to match demands
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Regulation of the CV System
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Peripheral Input
• Chemoreceptors
– Monitor metabolites, blood gases
• Mechanoreceptors
– Monitor movement and pressure
• Baroreceptors
– Monitor blood pressure in arteries
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Carotid Artery Palpation
• HR is often monitored using the carotid
arteries.
• Pressure on baroreceptors may decrease HR.
• Alternatives include
– HR monitor
– Radial or temporal pulse
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Nutrition, and Human Performance, Sixth Edition
Distribution of Blood
• Predominantly directed by
– Vasodilation
– Vasoconstriction
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Physical Factors Affecting
Blood Flow
Flow = Pressure gradient × Vessel radius4
Vessel length × Viscosity
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Nutrition, and Human Performance, Sixth Edition
Effect of Exercise
• At the start of exercise
– Dilation of local arterioles
– Vessels to nonactive tissues constrict
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Effect of Exercise
• At rest, only 1 of every 30 – 40 capillaries is
open in skeletal muscle.
• During exercise, capillaries open and increase
perfusion and O2 delivery.
• Vasodilation mediated by
– Temp – pH
– CO2 – Adenosine
– NO – K+
– MG+
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Nitric Oxide (NO)
• Produced and released by vascular
endothelium
• NO spreads through cell membranes to
muscle within vessel walls, causing
relaxation.
• Net result is vasodilation.
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Hormonal Factors
• Adrenal medulla releases
– Epinephrine
– Norepinephrine
• Cause vasoconstriction
– Except in coronary arteries and skeletal muscles
• Minor role during exercise
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition
Exercising After Cardiac
Transplantation
• Depressed cardiac output
• Increased stroke volume
Copyright © 2007 Lippincott Williams & Wilkins. McArdle, Katch, and Katch: Exercise Physiology: Energy,
Nutrition, and Human Performance, Sixth Edition