Chronic Cardiopulmonary Adaptations to Exercise

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Chronic Responses to Exercise[edit | edit source]

This page will focus on chronic responses to exercise stimuli, thus changes that occur when an individual is regularly training or involved in an appropriate exercise regime for their specific goals and sport.

Cardiopulmonary Responses[edit | edit source]

Adaptations to Training: Cardiovascular changes at Rest[edit | edit source]

These will refer to the before and after changes noticeable when an individual started training regularly (i.e. changes from pre-training (week 0) to changes post-training (week 12)), while the individual is at rest.

  • Decrease in resting heart rate because:
    • Sympathetic drive decreases[1]
    • Atrial contraction rate decreases
    • Normal resting heart = 60 to 100 beats per minute[2]
    • Increase in stroke volume (SV)[3]
      • Read about the relationship between stroke volume and heart rate here _ link to acute responses


  • Decrease in blood pressure[5]
    • The decrease in systolic blood pressure will be greater than the decrease in diastolic blood pressure[6] and this is related to a decrease in peripheral vascular resistance.[7]
  • Increase in total blood volume with the maintained concentration of haemoglobin
    • Blood volume = amount of blood circulating through the body
    • Increase in plasma volume[8]
    • Increase in red blood cells
    • Increase in haemoglobin mass[9]
    • Oxygen-carrying capacity increases

Adaptations to Training: Cardiovascular Changes with Exercise[edit | edit source]

Comparing changes with exercise between pre and post training programme (e.g. a person doing a graded exercise test before commencing a training programme (week 0) and then doing the same test at week 12)

At any given work load:

  • Decrease in heart rate
  • Increase in stroke volume up to 50% of maximal workload[10]
    • Increase in myocardial contractility[11]
    • Increase in ventricular volume [12]
  • Cardiac output (Q) stays the same at any given load (pre versus post)
    • Cardiac output (Q) = Stroke volume (SV) x Heart rate (HR)
    • This is because of the increased stroke volume, and decrease in heart rate
    • Increase of cardiac output only at maximum heart rate (HRmax) due to the concurrent increase in stroke volume (Remember maximum heart rate is not trainable, thus at maximum heart rate and with an increase in stroke volume this will result in increased cardiac output at maximum heart rate)
  • Decrease in cardiac output only if there is a change in efficiency or significant weight loss

Decrease in blood flow per kilogram of working muscle

             Compensated by increased oxygen (o2) extraction

Decrease in myocardial VO2 at any given workload

Myocardial hypertrophy

Decrease heart rate

Adaptations to Aerobic Training: Cardiorespiratory endurance

Aerobic =

Cardiorespiratory endurance

             Ability to sustain prolonged, dynamic exercise

             Improvements achieved through multisystem adaptations (cardiovascular, respiratory, muscle, metabolic)

Endurance training

             Increase in maximal endurance capacity – Increase in V02 max

             Increase in submaximal endurance capacity

                            Lower heart rate at same submaximal exercise intensity

                            More related to competitive endurance performance

O2 Transport system and Fick equation

V02 = SV X HR X (a-v)O2 difference

↑ VO2max = ↑ max SV x → HR x ↑ max (a -v)O2 difference

Heart Size

With training, heart mass and LV volume ↑

↑ Target pulse rate (TPR) → cardiac hypertrophy → ↑ SV

↑ Plasma volume → ↑ LV volume → ↑ EDV → ↑ SV

Volume loading effect

SV ↑ after training

Resting, submaximal, and maximal

Plasma volume ↑ with training → ↑ EDV → ↑ preload

Resting and submaximal HR ↓ with training → ↑ filling time → ↑ EDV

↑ LV mass with training → ↑ force of contraction

Attenuated ↑ TPR with training → ↓ afterload

SV adaptations to training ↓ with age

perhaps add table of SV at rest and maximal exercise for different states of training

Resting HR

↓ markedly (~ 1 beat/minute per week of training)

↑ Parasympathetic, ↓ sympathetic activity in heart

Submaximal heart rate

↓ HR for same given absolute intensity

more noticeable at higher submaximal intensities

Maximal heart rate

No significant changes with training

↓ with age

HR -SV interactions

Does ↓ HR → ↑ SV? Does ↑ SV → ↓ HR?

HR, SV interact to optimise cardiac output

HR recovery

Faster recovery with training

Indirect index of cardiorespiratory fitness

Cardiac output (Q)

Training creates little to no change at rest, submaximal exercise

Maximal Q ↑ considerable (due to ↑ SV)

↑ Blood flow to active muscle

↑ Cappilirisation , capillary recruitment

↑ Capillary: Muscle fibre ratio

↑ Total cross-sectional area for capillary exchange

↓Blood flow to inactive regions

↑ Total blood volume

Prevents any decrease in venous return as a result of more blood in capillaries

Blood pressure

↓ BP at given submaximal intensity

↑ Systolic BP, ↓ diastolic BP at maximal intensity

Blood volume: total volume ↑ rapidly

↑ Plasma volume via ↑ plasma proteins, ↑ water and Na+ retention (all in first 2 weeks)

↑ Red blood cell volume (though hematocrit may ↓)

↓ Plasma viscosity

Add info on adaptations in blood volume and hematocrit with training

Adaptations to Training: Pulmonary (at Rest)

Potential ↑ in lung volumes

Improved pulmonary function

No change in TV (Tidal volume)

↑ Diffusion capacity

↑ lung volumes

↑alveolar - capillary surface area

↑ blood volume

Adaptations to Training: Pulmonary (Exercise)

↑ diffusion capacity

↑ minute ventilation

↑ ventilatory efficiency

↓ Ve at any given workload

↑ diffusion capacity

Adaptations to Training: Metabolic/ Morphologic (Rest)

Skeletal muscle hypertrophy

↑ capillary density

↑ number and size of mitochondria

↑ myoglobin concentration

↑ rate of O2 transport

Adaptations to Training: Metabolic/Morphologic (Exercise)

↓ rate of glycogen depletion at any given workload

↑ capacity to mobilise and oxidise fat

↑ oxidative potential of the mitochondria

↑ glycogen storage

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Resources[edit | edit source]

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References[edit | edit source]

  1. Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise. Sports medicine. 2008 Aug;38(8):633-46.
  2. Olshansky B, Ricci F, Fedorowski A. Importance of Resting Heart Rate: Heart rate and Outcomes. Trends in Cardiovascular Medicine. 2022 May 25.
  3. Gould C, Hopper J. Applied cardiovascular physiology. Anaesthesia & Intensive Care Medicine. 2022 Mar 18.
  4. Whats Up Dude. What Is Stroke Volume Of The Heart - Stroke Volume Variation - Stroke Volume And Heart Rate. Available from: [last accessed 28/11/2022]
  5. Barone Gibbs B, Hivert MF, Jerome GJ, Kraus WE, Rosenkranz SK, Schorr EN, Spartano NL, Lobelo F, American Heart Association Council on Lifestyle and Cardiometabolic Health; Council on Cardiovascular and Stroke Nursing; and Council on Clinical Cardiology. Physical activity as a critical component of first-line treatment for elevated blood pressure or cholesterol: who, what, and how?: a scientific statement from the American Heart Association. Hypertension. 2021 Aug;78(2):e26-37.
  6. Alpsoy Ş. Exercise and hypertension. Physical Exercise for Human Health. 2020:153-67.
  7. Fagard RH. Exercise is good for your blood pressure: effects of endurance training and resistance training. Clinical and Experimental Pharmacology and Physiology. 2006 Sep;33(9):853-6.
  8. Rhibi F, Prioux J, Attia MB, Hackney AC, Zouhal H, Abderrahman AB. Increase interval training intensity improves plasma volume variations and aerobic performances in response to intermittent exercise. Physiology & behavior. 2019 Feb 1;199:137-45.
  9. Skattebo Ø, Bjerring AW, Auensen M, Sarvari SI, Cumming KT, Capelli C, Hallén J. Blood volume expansion does not explain the increase in peak oxygen uptake induced by 10 weeks of endurance training. European Journal of Applied Physiology. 2020 May;120(5):985-99.
  10. Pakkala A. Chapter-5 Cardiorespiratory Adaptation to Exercise. MED CAL SCIENCES. 2020:69.
  11. Seo DY, Kwak HB, Kim AH, Park SH, Heo JW, Kim HK, Ko JR, Lee SJ, Bang HS, Sim JW, Kim M. Cardiac adaptation to exercise training in health and disease. Pflügers Archiv-European Journal of Physiology. 2020 Feb;472(2):155-68.
  12. Hellsten Y, Nyberg M. Cardiovascular adaptations to exercise training. Compr Physiol. 2015 Dec 15;6(1):1-32.