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Centre for Heart and Chest Research, Monash Medical Centre and Monash University, Melbourne, Australia
Although many factors are thought to contribute
to the regulation of metabolic vasodilation in skeletal muscle
vasculature, recent interest has focused on the role of the
endothelium. We examined the relative roles of nitric oxide (NO) and of
vasodilator prostanoids in the control of metabolically induced
functional hyperemia in the forearm of humans. In 43 healthy volunteers
[24 ± 5 (SD) yr] we assessed resting and functional
hyperemic blood flow (FHBF) in response to 2 min of isotonic forearm
exercise before and after inhibition of NO and/or vasodilator
prostanoid production with intra-arterial
NG-monomethyl-L-arginine
(L-NMMA, 2 mg/min) and aspirin
(ASA, 3 mg/min), respectively. Blood flow was measured using venous
occlusion plethysmography.
L-NMMA and ASA decreased resting
forearm blood flow by 42% (P < 0.0001) and 23% (P < 0.0001),
respectively, whereas infusion of ASA followed by
L-NMMA reduced flow by a further
24% (P < 0.05).
L-NMMA reduced peak FHBF by 18%
[from 13.9 ± 1.0 to 11.4 ± 1.1 (SE)
ml · 100 ml
forearm
1 · min
1,
P = 0.003] and the volume
"repaid" after 1 and 5 min by 25% (8.9 ± 0.7 vs. 6.7 ± 0.7 ml/100 ml, P < 0.0001)
and 37% (26.6 ± 1.8 vs. 16.8 ± 1.6 ml/100 ml,
P < 0.0001). ASA similarly reduced peak FHBF by 19% (from 14.5 ± 1.1 to 11.8 ± 0.9 · 100 ml
forearm
1 · min
1,
P < 0.001) and the volume repaid
after 1 and 5 min by 14% (7.5 ± 0.6 vs. 6.4 ± 0.6 ml/100 ml,
P = 0.0001) and 20% (21.2 ± 1.5 vs. 16.9 ± 1.5 ml/100 ml, P < 0.0001), respectively. The coinfusion of ASA and
L-NMMA did not decrease FHBF to
a greater extent than either agent alone. These data suggest that
endothelium-derived NO and vasodilator prostanoids contribute to
resting blood flow and metabolic vasodilation in skeletal muscle
vasculature in healthy humans. Although these vasodilator mechanisms
operate in parallel in exercise-induced hyperemia, they appear not to
be additive. Other mechanisms must also be operative in metabolic vasodilation.
regional blood flow; endothelium-derived factors; exercise; eicosanoids; nitric oxide
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