Respiratory and cardiovascular adaptations to exercise

Transcription

1 Respiratory and cardiovascular adaptations to exercise Modul BIO /05/2011 Vergès Samuel CR INSERM, HP2 Laboratory (U1042), Joseph Fourier University, Grenoble Exercise Research Unit, CHU Grenoble Cardiorespiratory exercise response Respiratory system Cardiovascular system O 2 transport capacity Muscle O 2 delivery and utilization ERGOMETRY 1

2 Incremental protocol / Constant-load protocol Load Incremental protocol Constant-load protocol Time Incremental protocol / constant-load protocol - Incremental test until exhaustion - Constant-load test to exhaustion - TIME TRIAL (constant distance): 3000 m running test, 40 km cycling test - TIME TRIAL (time constant): 12 min Cooper Test Heart and circulation 2

3 Heart Heart ECG 3

4 ECG HEART RATE: MEASUREMENT HEART RATE MONITOR 4

5 3-CHANEL ECG 12-CHANEL ECG Heart rate abnormalities Normal Signal Bradicardia Tachicardia Atrioventricular blocks Ventricular fibrillation 5

6 Heart rate: resting values Alter oder Trainings-Status Schläge pro Minute Babys, bis 1 Jahr: Kinder, 1 bis 10 Jahre: Kinder, >10 Jahre und Erwachsene: Gut trainierte Athleten: Heart rate during exercise Constant load exercise (LOW, MODERATE and HIGH INTENSITIES) Heart rate during exercise Incremental running test 6

7 Maximal heart rate: ageing Maximal heart rate: ageing HR max = 220 AGE HR max = 208 [0.7 AGE] Heart rate: effect of training 7

8 Heart rate variability TACHOGRAM Heart rate variability kl Spectral analysis of heart rate variability Heart rate variability Cardiovascular abnormalities Training status 8

9 Muscle sympathetic nerve activity Blood pressure measurement Blood pressure measurement 9

10 Blood pressure measurement Blood pressure measurement Hypertension 10

11 Increased blood pressure systolisch diastolisch Kategorie (mmhg) (mmhg) Normal < 120 < 80 Hochnormal Bluthochdruck Stadium Stadium Classification for adults Blood pressure during exercise Blood pressure during exercise 11

12 Blood flow measurement DOPPLER ULTRASOUND Blood flow Cardiac output (l/min) = Stroke volume (l) X Heart rate (cycles/min) Blood flow during exercise 12

13 Blood flow and training status Blood flow and training status Maximal blood flow and training status MAXIMAL BLOOD FLOW SV (ml) HR (min) Qc (l. min -1 ) Non trained Endurance trained

14 Respiratory system Respiratory measurement 14

15 Respiratory measurement Respiratory measurement Respiratory measurement LILLY PNEUMOTACHOGRAPH 15

16 Respiratory measurement Flow volume curve Ageing and FEV1 Einsekunden-Kapazität (FEV 1 ) Abnormal lung function 16

17 Respiratory measurement Maximal voluntary ventilation Ageing and MVV AGE (years) Maximal voluntary ventilation Respiratory measurement Helium dilution method 17

18 Respiratory measurement BODY PLETHYSMOGRAPHY Respiratory measurement Rib cage signal Abdominal signal INDUCTION PLETHYSMOGRAPHY Respiratory measurement OPTOELECTRONIC PLETHYSMOGRAPHY 18

19 LIFESHIRT Respiratory muscles Inspiration Expiration Respiratory muscle pressure measurements P es P ga P di = P ga - P es Esophagus and gastric balloons Rest End Exp. End Insp. P es -5 cmh 2 O -8 cmh 2 O P ga +8 cmh 2 O +13cmH 2 O P di +13 cmh 2 O +21 cmh 2 O 19

20 Respiratory muscle work W = P x V Respiratory muscle force Phrenic nerve magnetic stimulation Respiratory muscle force 20

21 Respiratory muscle force: ageing AGE (years) MAXIMAL INSPIRATORY PRESSURE AGE (years) MAXIMAL EXPIRATORY PRESSURE Energy consumption: measurements DIRECT CALORIMETRY Gas exchange measurements INDIRECT CALORIMETRY 21

22 Gas exchange measurements INDIRECT CALORIMETRY Gas exchange measurements Mouth Air to/from the room Gas Analyse Pneumotachograph 2-WAY VALVE 3-WAY VALVE Gas exchange measurements 22

23 Gas exchange calculation Substrate energy-equivalence : CHO: 4.1 kcal/g Fat: 9.4 kcal/g Protein: 4.1 kcal/g Energy per Liter of oxygen: CHO: 5.0 kcal/l Fat: 4.7 kcal/l Protein: 4.5 kcal/l. Example: VO 2 Rest. = L/min 60 min/h, 24 h/d, 4.8 kcal/lo 2 Total VO 2 = 432 L/d Total energy consumption = 2074 kcal/d Respiratory exchange ratio.. RER = VCO 2 / VO 2 Resting value: Respiratory exchange ratio Energy % kcal RER kcal/l O 2 Carbohydrates Fats

24 Ventilation and gas exchange during exercise Incremental protocol / Constant-load protocol Load Incremental protocol Constant-load protocol Time Ventilation during exercise Ventilation during constant-load exercise 24

25 Ventilation during exercise. V E (l min -1 ) Incremental protocol V T (l) f R (cycles min -1 ) Time Time Time O 2 consumption: FICK Equation. O 2 consumption (VO 2 ) = Cardiac output (CO) x Arterio-venous O 2 -Difference (Da-vO 2 ) O 2 consumption during exercise Constant load test 25

26 VO 2 (ml min kg -1 ) O 2 consumption during exercise. Treadmill velocity (km h -1 ) Incremental test Substrate utilization during exercise 100% 90% 80% 70% 60% 50% 40% 30% Protein Glycogen Fat 20% 10% 0% Rest Light- Moderate High-intensity High-intensity Sprint Endurance Substrate utilization during exercise % Total energy expenditure Carbohydrate Fat Exercise time in hours Constant-load moderate intensity 26

27 Maximal oxygen consumption: ageing Maximal oxygen consumption: effect of training Maximal oxygen consumption: effect of training 27

28 Anaerobic threshold! Incremental test Anaerobic threshold Anaerobic threshold. 28

29 Anaerobic threshold Anaerobic threshold: effect of training 29