Int J Sports Med 2003; 24(7): 512-517
DOI: 10.1055/s-2003-42016
Physiology & Biochemistry
© Georg Thieme Verlag Stuttgart · New York

Circulatory Responses to Progressive Exercise: Insights from Positional Differences

T.  Rowland1 , A.  Garrison2 , A.  DeIulio2
  • 1Department of Pediatrics, Baystate Medical Center, Springfield, MA, USA
  • 2Department of Exercise Science, University of Massachusetts, Amherst, MA, USA
Further Information

Publication History

Accepted after revision: March 10, 2003

Publication Date:
10 September 2003 (online)

Abstract

The influence of body position on cardiac responses to progressive exercise was examined in 13 healthy circumpubertal boys. The subjects (mean age 12.5 ± 1.4 y) performed a progressive cycle test with an identical protocol in the sitting and supine positions. Stroke volume and left ventricular dimensions were assessed with Doppler and two-dimensional echocardiography, respectively. During supine exercise, no changes were seen in stroke volume or left ventricular preload (end-diastolic dimension) with increasing exercise intensity. At rest, mean values for stroke volume and cardiac output were 16.4 % and 27.1 % lower, respectively, with subjects upright compared to supine. With upright exercise these variables rose to become insignificantly different than supine values. Stroke volume while cycling upright rose by 29 % by the second workload but remained stable at higher work intensities. The initial increase in stroke volume observed only when cycling upright presumably reflects mobilization of dependent blood in the lower extremities. The mechanisms governing cardiac responses to exercise when supine and upright are otherwise identical.

References

  • 1 Bevegard S, Holmgren A, Jonsson B. The effect of body position on the circulation at rest and during exercise, with special reference to the influence on the stroke volume.  Acta Physiol Scand . 1960;  49 279-298
  • 2 Bevegard B S, Shepherd J T. Regulation of the circulation during exercise in man.  Physiol Rev. 1967;  47 178-213
  • 3 Braunwald E, Sarnoff R J, Stainsby W N. Determinants of duration and mean rate of ventricular ejection.  Circ Res . 1958;  6 319-325
  • 4 Christie J, Sheldahl L M, Tristani F E, Sugar K B, Ptacin M J, Wann S. Determination of stroke volume and cardiac output during exercise: comparison of two-dimensional and Doppler echocardiography, Fick oximetry, and thermodilution.  Circulation . 1987;  76 539-547
  • 5 Daley P J, Sagar K B, Wann L S. Doppler echocardiographic measurement of flow velocity in the ascending aorta during supine and upright exercise.  Br Heart J . 1985;  54 562-567
  • 6 Higginbotham M B, Morris K G, Williams R S, McHale P A, Coleman R E, Cobb F R. Regulation of stroke volume during submaximal and maximal exercise in normal man.  Circ Res . 1986;  58 281-291
  • 7 Leyk D, Essfield D, Hoffmann U, Wunderlich H E, Baum K, Stegemann J. Postural effect on cardiac output, oxygen uptake and lactate during cycle exercise of varying intensity.  Eur J Appl Physiol . 1994;  68 30-35
  • 8 Linden R J. The size of the heart.  Cardioscience . 1994;  5 225-233
  • 9 Martin R R, Haines H. Application of LaPlace’s Law to mammalian hearts.  Comp Biochem Physiol . 1970;  34 959-962
  • 10 Notarius C F, Magder S. Central venous pressure during exercise: role of the muscle pump.  Can J Physiol Pharmacol . 1996;  74 647-651
  • 11 Nottin S, Vinet A, LeCoq A M, Obert P. Test-retest reproducibility of submaximal and maximal cardiac output by Doppler echocardiography and CO2 rebreathing in prepubertal children.  Pediatr Exerc Science . 2001;  13 214-224
  • 12 Nottin S, Vinet A, Stecken F. Central and peripheral adaptations during maximal cycle exercise in boys and men.  Med Sci Sports Exerc . 2002;  34 456-463
  • 13 Poliner L R, Dehmer G J, Lewis S E, Parkey R W, Blomquist C G, Willerson J T. Left ventricular performance in normal subjects: a comparison of the responses to exercise in the upright and supine positions.  Circulation . 1980;  62 528-534
  • 14 Pollack A A, Wood E H. Venous pressure in the saphenous vein at the ankle in man during exercise and changes in posture.  J Appl Physiol . 1949;  1 649-662
  • 15 Rowland T, Blum J W. Cardiac dynamics during upright cycle exercise in boys.  Am J Hum Biol . 2000;  12 749-757
  • 16 Rowland T, Kline G, Goff D. Physiological determinants of maximal aerobic power in healthy 12-year old boys.  Pediatr Exerc Science . 1999;  11 317-326
  • 17 Rowland T, Obert P. Doppler echocardiography for the estimation of cardiac output with exercise.  Sports Med. 2002;  32 1-13
  • 18 Rowland T, Popowski B, Ferrone L. Cardiac responses to maximal upright exercise in healthy boys and men.  Med Sci Sports Exerc. 1997;  29 1146-1151
  • 19 Rowland T, Potts J, Potts T, Sandor G, Goff D, Ferrone L. Cardiac responses to progressive exercise in normal children: a synthesis.  Med Sci Sports Exers. 2000;  32 255-259
  • 20 Rushmer R F. Constancy of stroke volume to ventricular responses to exertion.  Am J Physiol . 1959;  196 745-750
  • 21 Rushmer R F. Cardiovascular dynamics. Fourth Edition. Philadelphia; W.B. Saunders 1976: 264-267.
  • 22 Stegall H F. Muscle pumping in the dependent leg.  Circ Res . 1966;  19 180-190
  • 23 Stenberg J, Astrand P O, Ekblom B, Royce B, Saltin B. Hemodynamic response to work with different muscle groups, sitting and supine.  J Appl Physiol . 1967;  22 61-70
  • 24 Thandani U, Prker J O. Hemodynamics at rest and during supine and sitting bicycle exercise in normal subjects.  Am J Cardiol . 1978;  41 52-59

T. Rowland, M.D.

Department of Pediatrics

Baystate Medical Center · Springfield · MA 01199 · USA

Phone: +1 413 794 7350

Fax: +1 413 794 7140

Email: thomas.rowland@bhs.org

    >