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A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions

The physiological response to physical exercise is now recognized as an important tool which can aid the diagnosis and treatment of cardiovascular diseases. This is due to the fact that several mechanisms are needed to accommodate a higher cardiac output and a higher oxygen delivery to tissues. The...

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Autores principales: Fresiello, Libera, Meyns, Bart, Di Molfetta, Arianna, Ferrari, Gianfranco
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896934/
https://www.ncbi.nlm.nih.gov/pubmed/27375488
http://dx.doi.org/10.3389/fphys.2016.00189
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author Fresiello, Libera
Meyns, Bart
Di Molfetta, Arianna
Ferrari, Gianfranco
author_facet Fresiello, Libera
Meyns, Bart
Di Molfetta, Arianna
Ferrari, Gianfranco
author_sort Fresiello, Libera
collection PubMed
description The physiological response to physical exercise is now recognized as an important tool which can aid the diagnosis and treatment of cardiovascular diseases. This is due to the fact that several mechanisms are needed to accommodate a higher cardiac output and a higher oxygen delivery to tissues. The aim of the present work is to provide a fully closed loop cardiorespiratory simulator reproducing the main physiological mechanisms which arise during aerobic exercise. The simulator also provides a representation of the impairments of these mechanisms in heart failure condition and their effect on limiting exercise capacity. The simulator consists of a cardiovascular model including the left and right heart, pulmonary and systemic circulations. This latter is split into exercising and non-exercising regions and is controlled by the baroreflex and metabolic mechanisms. In addition, the simulator includes a respiratory model reproducing the gas exchange in lungs and tissues, the ventilation control and the effects of its mechanics on the cardiovascular system. The simulator was tested and compared to the data in the literature at three different workloads whilst cycling (25, 49 and 73 watts). The results show that the simulator is able to reproduce the response to exercise in terms of: heart rate (from 67 to 134 bpm), cardiac output (from 5.3 to 10.2 l/min), leg blood flow (from 0.7 to 3.0 l/min), peripheral resistance (from 0.9 to 0.5 mmHg/(cm(3)/s)), central arteriovenous oxygen difference (from 4.5 to 10.8 ml/dl) and ventilation (6.1–25.5 l/min). The simulator was further adapted to reproduce the main impairments observed in heart failure condition, such as reduced sensitivity of baroreflex and metabolic controls, lower perfusion to the exercising regions (from 0.6 to 1.4 l/min) and hyperventilation (from 9.2 to 40.2 l/min). The simulator we developed is a useful tool for the description of the basic physiological mechanisms operating during exercise. It can reproduce how these mechanisms interact and how their impairments could limit exercise performance in heart failure condition. The simulator can thus be used in the future as a test bench for different therapeutic strategies aimed at improving exercise performance in cardiopathic subjects.
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spelling pubmed-48969342016-07-01 A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions Fresiello, Libera Meyns, Bart Di Molfetta, Arianna Ferrari, Gianfranco Front Physiol Physiology The physiological response to physical exercise is now recognized as an important tool which can aid the diagnosis and treatment of cardiovascular diseases. This is due to the fact that several mechanisms are needed to accommodate a higher cardiac output and a higher oxygen delivery to tissues. The aim of the present work is to provide a fully closed loop cardiorespiratory simulator reproducing the main physiological mechanisms which arise during aerobic exercise. The simulator also provides a representation of the impairments of these mechanisms in heart failure condition and their effect on limiting exercise capacity. The simulator consists of a cardiovascular model including the left and right heart, pulmonary and systemic circulations. This latter is split into exercising and non-exercising regions and is controlled by the baroreflex and metabolic mechanisms. In addition, the simulator includes a respiratory model reproducing the gas exchange in lungs and tissues, the ventilation control and the effects of its mechanics on the cardiovascular system. The simulator was tested and compared to the data in the literature at three different workloads whilst cycling (25, 49 and 73 watts). The results show that the simulator is able to reproduce the response to exercise in terms of: heart rate (from 67 to 134 bpm), cardiac output (from 5.3 to 10.2 l/min), leg blood flow (from 0.7 to 3.0 l/min), peripheral resistance (from 0.9 to 0.5 mmHg/(cm(3)/s)), central arteriovenous oxygen difference (from 4.5 to 10.8 ml/dl) and ventilation (6.1–25.5 l/min). The simulator was further adapted to reproduce the main impairments observed in heart failure condition, such as reduced sensitivity of baroreflex and metabolic controls, lower perfusion to the exercising regions (from 0.6 to 1.4 l/min) and hyperventilation (from 9.2 to 40.2 l/min). The simulator we developed is a useful tool for the description of the basic physiological mechanisms operating during exercise. It can reproduce how these mechanisms interact and how their impairments could limit exercise performance in heart failure condition. The simulator can thus be used in the future as a test bench for different therapeutic strategies aimed at improving exercise performance in cardiopathic subjects. Frontiers Media S.A. 2016-06-08 /pmc/articles/PMC4896934/ /pubmed/27375488 http://dx.doi.org/10.3389/fphys.2016.00189 Text en Copyright © 2016 Fresiello, Meyns, Di Molfetta and Ferrari. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Physiology
Fresiello, Libera
Meyns, Bart
Di Molfetta, Arianna
Ferrari, Gianfranco
A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title_full A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title_fullStr A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title_full_unstemmed A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title_short A Model of the Cardiorespiratory Response to Aerobic Exercise in Healthy and Heart Failure Conditions
title_sort model of the cardiorespiratory response to aerobic exercise in healthy and heart failure conditions
topic Physiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4896934/
https://www.ncbi.nlm.nih.gov/pubmed/27375488
http://dx.doi.org/10.3389/fphys.2016.00189
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