Cardiovascular responses to upper body exercise in normals and cardiac patients.

This review summarizes and contrasts the cardiovascular responses elicited during dynamic upper body exercise (UBE) with those associated with lower body exercise (LBE). Information was obtained from studies which utilized arm-crank and/or cycle ergometers. At any given submaximal oxygen uptake (VO2), cardiac output (Q) is similar for UBE and LBE; however, heart rate (HR) is higher and stroke volume (SV) lower during UBE. Peripheral resistance and systolic and diastolic blood pressure are greater during UBE. Maximal Q, HR, SV, workload, and VO2 are less for UBE. As observed with healthy individuals, cardiac patients experience greater physiological stress for any given VO2 during UBE. UBE offers a satisfactory but perhaps not equivalent alternative to LBE for evaluation of angina and ischemic responses to exercise. The central and peripheral responses to either upper or lower body exercise appear to be independent of the muscle mass but directly related to the ergometer specific relative exercise intensity. The control mechanisms which govern these responses appear to be a centrally mediated activation of medullary centers coupled with a chemoreflex arising in the exercising skeletal muscle.