The circulation of blood during upright exercise involves a two-pump system, a central
cardiac pump and a peripheral pump responsible for systemic venous return. Axiomatically,
the function of the two pumps must be equal, and certain evidence suggests that the
peripheral pump may “drive” the circulation during exercise. Despite its potential
importance to circulatory reserve and aerobic fitness, little is known regarding the
determinants of the peripheral pump. Pumping function of skeletal muscle and the suction
effect of the left ventricle presumably are principal factors in defining systemic
venous return. This review, which focuses on data in humans, examines current information
regarding the peripheral pump and its potential role as a critical determinant of
maximal cardiac output, maximal oxygen uptake, and endurance fitness.
Key words:
Cardiac output, exercise, physical fitness.
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T. W. Rowland, M. D.
Department of Pediatrics
Baystate Medical Center
Springfield, MA 01199
USA
Phone: +01(413) 794 7350
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