The interest in the study of ventricular function has grown considerably in the last decades. In this review, we analyse the extreme values of ventricular function as obtained with Doppler echocardiography. We mainly focus on the parameters that have been used throughout the history of Doppler echocardiography to assess left ventricular (LV) systolic and diastolic function. The 'athlete's heart' would be the highest expression of ventricular function whereas its lowest expression is represented by the failing heart, independently from the original aetiology leading to this condition. There are, however, morphological similarities (dilation and hypertrophy) between the athlete's and the failing heart, which emerge as physiological and pathophysiological adaptations, respectively. The introduction of new assessment techniques, specifically speckle tracking, may provide new insight into the properties that determine ventricular filling, specifically left ventricular twisting. The concept of ventricular function must be always considered, although it may not be always possible to distinguish the normal heart of sedentary individuals from that of highly trained hearts based solely on echocardiographic or basic studies.
The use of automated gas exchange analysis systems in exercise studies is common throughout the industrialized world and are frequently used in sports medicine laboratories for the measurement of maximal oxygen uptake (VO 2max ), as an integrative parameter that allows the physical condition to be assessed, in spite of its limitations. Actually, the fundamental principles behind the measurement of respiratory gas exchange (RGE) have not changed for a century. It was used a manual Douglas bag method together with separate chemical analyses. The need for faster and more efficient techniques, has conditioned the traditional procedures and determined the emergence of automated systems. However, the validity and reliability of all these different systems is not well known. The common features associates with these systems, also have disadvantages that must be evaluated at the time of the acquisition of an automated equipment: (1) regular quality control checks, which entails other added economic costs, (2) the validity and reliability of the results, which it is necessary to verify, and (3) the user does not know the equations that determine the values of oxygen consumption and carbon dioxide production. This work aims to clarify the disadvantages of these automated systems. At maximum intensities, the variation of VO 2max or VO 2peak can be very significant in athletes and even more relevant in sick people undergoing a training program. Therefore, considerable care is needed when comparing RGE data with automated systems. NEW AND NOTEWORTHYActually, stress tests are more conveniently performed with automated systems. It is necessary to examine the validity and reliability of automated respiratory gas exchange systems. The algorithms incorporated in the software, apart from being a "mystery," show differences with respect to the data provided.
Endurance exercise is a model of physiological integration. There is no other animal activity in which cardiovascular, respiratory, metabolic-endocrine and neuromuscular functions are activated at the same time. Even apparently, silent functions are essential during exercise (digestive, renal). During long-term exercise, the absorption of water and carbohydrates is a determining factor in performance. Kidney function plays a fundamental role in trying to preserve the hydro-electrolyte balance during exercise. In this work we present an integrative physiological perspective during dynamic exercise (mobilization of a large muscle mass with a low to moderate degree of strength development), both from the point of view of health and performance. The response of the heart rate in the first moments of exercise is a good example of the feedforward mechanism. Overall, the nervous system has two control mechanisms: feedforward and feedback. These depend on the central command, a more functional than anatomical entity. The feedforward system allows to immediately start the cardiovascular and respiratory systems. This mechanism is important because it activates the organism to overcome resting state. The feedback system is equally important because it allows the central command to receive the necessary information to “order” the appropriate response according to the intensity of the exercise. The information for retrocontrol comes from various receptors located in: the muscles, the respiratory system and the cardiovascular system. It is complex information that the central nervous system processes with exquisite precision, as can be seen in in endurance exercise.
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