Rick E. Carlson

Endothelium-dependent vasodilatation and exercise hyperaemia in ageing humans: impact of acute ascorbic acid administration

Age‐related increases in oxidative stress impair endothelium‐dependent vasodilatation in humans, leading to the speculation that endothelial dysfunction contributes to impaired muscle blood flow and vascular control during exercise in older adults. We directly tested this hypothesis in 14 young (22 ± 1 years) and 14 healthy older men and women (65 ± 2 years). We measured forearm blood flow (FBF; Doppler ultrasound) and calculated vascular conductance (FVC) responses to single muscle contractions at 10, 20 and 40% maximum voluntary contraction (MVC) before and during ascorbic acid (AA) infusion, and we also determined the effects of AA on muscle blood flow during mild (10% MVC) continuous rhythmic handgrip exercise. For single contractions, the peak rapid hyperaemic responses to all contraction intensities were impaired ∼45% in the older adults (all P < 0.05), and AA infusion did not impact the responses in either age group. For the rhythmic exercise trial, FBF (∼28%) and FVC (∼31%) were lower (P= 0.06 and 0.05) in older versus young adults after 5 min of steady‐state exercise with saline. Subsequently, AA was infused via brachial artery catheter for 10 min during continued exercise. AA administration did not significantly influence FBF or FVC in young adults (1–3%; P= 0.24–0.59), whereas FBF increased 34 ± 7% in older adults at end‐exercise, and this was due to an increase in FVC (32 ± 7%; both P < 0.05). This increase in FBF and FVC during exercise in older adults was associated with improvements in vasodilator responses to acetylcholine (ACh; endothelium dependent) but not sodium nitroprusside (SNP; endothelium independent). AA had no effect on ACh or SNP responses in the young. We conclude that acute AA administration does not impact the observed age‐related impairment in the rapid hyperaemic response to brief muscle contractions in humans; however, it does significantly increase muscle blood flow during continuous dynamic exercise in older adults, and this is probably due (in part) to an improvement in endothelium‐dependent vasodilatation.

Mechanical influences on skeletal muscle vascular tone in humans: insight into contraction-induced rapid vasodilatation

We tested the hypothesis that mechanical deformation of forearm blood vessels via acute increases in extravascular pressure elicits rapid vasodilatation in humans. In healthy adults, we measured forearm blood flow (Doppler ultrasound) and calculated forearm vascular conductance (FVC) responses to whole forearm compressions and isometric muscle contractions with the arm above heart level. We used several experimental protocols to gain insight into how mechanical factors contribute to contraction‐induced rapid vasodilatation. The findings from the present study clearly indicate that acute increases in extravascular pressure (200 mmHg for 2 s) elicit a significant rapid vasodilatation in the human forearm (peak ΔFVC∼155%). Brief, 6 s sustained compressions evoked the greatest vasodilatation (ΔFVC∼260%), whereas the responses to single (2 s) and repeated compressions (five repeated 2 s compressions) were not significantly different (ΔFVC∼155%versus∼115%, respectively). This mechanically induced vasodilatation peaks within 1–2 cardiac cycles, and thus is dissociated from the temporal pattern normally observed in response to brief muscle contractions (∼4–7 cardiac cycles). A non‐linear relation was found between graded increases in extravascular pressure and both the immediate and peak rapid vasodilatory response, such that the responses increased sharply from 25 to 100 mmHg, with no significant further dilatation until 300 mmHg (maximal ΔFVC∼185%). This was in contrast to the linear intensity‐dependent relation observed with muscle contractions. Our collective findings indicate that mechanical influences contribute largely to the immediate vasodilatation (first cardiac cycle) observed in response to a brief, single contraction. However, it is clear that there are additional mechanisms related to muscle activation that continue to cause and sustain vasodilatation for several more cardiac cycles after contraction. Additionally, the potential contribution of mechanical influences to the total contraction‐induced hyperaemia appears greatest for low to moderate intensity single muscle contractions, and this contribution becomes less significant for sustained and repeated contractions. Nevertheless, this mechanically induced vasodilatation could serve as a feedforward mechanism to increase muscle blood flow at the onset of exercise, as well as in response to changes in contraction intensity, prior to alterations in local vasodilating substances that influence vascular tone.

Graded sympatholytic effect of exogenous ATP on postjunctional α-adrenergic vasoconstriction in the human forearm: implications for vascular control in contracting muscle

Recent evidence suggests that adenosine triphosphate (ATP) can inhibit vasoconstrictor responses to endogenous noradrenaline release via tyramine in the skeletal muscle circulation, similar to what is observed in contracting muscle. Whether this involves direct modulation of postjunctional α‐adrenoceptor responsiveness, or is selective for α1‐ or α2‐receptors remains unclear. Therefore, in Protocol 1, we tested the hypothesis that exogenous ATP can blunt direct postjunctional α‐adrenergic vasoconstriction in humans. We measured forearm blood flow (FBF; Doppler ultrasound) and calculated the vascular conductance (FVC) responses to local intra‐arterial infusions of phenylephrine (α1‐agonist) and dexmedetomidine (α2‐agonist) during moderate rhythmic handgrip exercise (15% maximum voluntary contraction), during a control non‐exercise vasodilator condition (adenosine), and during ATP infusion in eight young adults. Forearm hyperaemia was matched across all conditions. Forearm vasoconstrictor responses to direct α1‐receptor stimulation were blunted during exercise versus adenosine (ΔFVC =−11 ± 3%versus−39 ± 5%; P< 0.05), and were abolished during ATP infusion (−3 ± 2%). Similarly, vasoconstrictor responses to α2‐receptor stimulation were blunted during exercise versus adenosine (−13 ± 4%versus−40 ± 8%; P< 0.05), and were abolished during ATP infusion (−4 ± 4%). In Prototol 2 (n= 10), we tested the hypothesis that graded increases in ATP would reduce α1‐mediated vasoconstriction in a dose‐dependent manner compared with vasodilatation evoked via adenosine. Forearm vasoconstrictor responses during low dose adenosine (−38 ± 3%) and ATP (−33 ± 2%) were not significantly different from rest (−40 ± 3%; P> 0.05). In contrast, vasoconstrictor responses during moderate (−22 ± 6%) and high dose ATP (−8 ± 5%) were significantly blunted compared with rest, whereas the responses during adenosine became progressively greater (moderate =−48 ± 4%, P= 0.10; high =−53 ± 6%, P< 0.05). We conclude that exogenous ATP is capable of blunting direct postjunctional α‐adrenergic vasoconstriction, that this involves both α1‐ and α2‐receptor subtypes, and that this is graded with ATP concentrations. Collectively, these data are consistent with the conceptual framework regarding how muscle blood flow and vascular tone are regulated in contracting muscles of humans.

Combined inhibition of nitric oxide and vasodilating prostaglandins abolishes forearm vasodilatation to systemic hypoxia in healthy humans

Non‐technical summary  During hypoxia, there is less oxygen in the air we breathe and also in the blood being pumped away from the heart. Our blood vessels must relax in order to deliver more blood to match the resting oxygen demand of the muscles. The way in which multiple systems in the body coordinate this response is not well known. We examined the local response of the blood vessels to a hypoxic stimulus and show that two substances that the body produces, nitric oxide and prostaglandins, are necessary to cause relaxation of the blood vessels and increases in blood flow. These results help us better understand how oxygen delivery is regulated and may be especially important for populations that are unable to produce these substances that help increase blood flow, such as people with sleep apnoea, heart failure and diabetes.

Potassium, contracting myocytes and rapid vasodilatation: peaking more than just our interest?

Following a single brief muscle contraction in humans, skeletal muscle blood flow rapidly increases in a monophasic pattern that reaches a peak response in ∼4–5 seconds. Further, vasodilatation via smooth muscle cell hyperpolarization appears to be an essential determinant for this phenomenon (Hamann et al. 2004). Although the existence of contraction-induced rapid vasodilatation is apparent, a clear explanation of the mechanism(s) underlying this response has been difficult to uncover.

Mechanical Influences on Skeletal Muscle Vascular Tone in Humans: Insights into Contraction-Induced Rapid Vasodilation

We tested the hypothesis that mechanical deformation of forearm blood vessels via acute increases in extravascular pressure elicits rapid vasodilatation in humans. In healthy adults, we measured forearm blood flow (Doppler ultrasound) and calculated forearm vascular conductance (FVC) responses to whole forearm compressions and isometric muscle contractions with the arm above heart level. We used several experimental protocols to gain insight into how mechanical factors contribute to contraction-induced rapid vasodilatation. The findings from the present study clearly indicate that acute increases in extravascular pressure (200 mmHg for 2 s) elicit a significant rapid vasodilatation in the human forearm (peak DeltaFVC approximately 155%). Brief, 6 s sustained compressions evoked the greatest vasodilatation (DeltaFVC approximately 260%), whereas the responses to single (2 s) and repeated compressions (five repeated 2 s compressions) were not significantly different (DeltaFVC approximately 155% versus approximately 115%, respectively). This mechanically induced vasodilatation peaks within 1-2 cardiac cycles, and thus is dissociated from the temporal pattern normally observed in response to brief muscle contractions ( approximately 4-7 cardiac cycles). A non-linear relation was found between graded increases in extravascular pressure and both the immediate and peak rapid vasodilatory response, such that the responses increased sharply from 25 to 100 mmHg, with no significant further dilatation until 300 mmHg (maximal DeltaFVC approximately 185%). This was in contrast to the linear intensity-dependent relation observed with muscle contractions. Our collective findings indicate that mechanical influences contribute largely to the immediate vasodilatation (first cardiac cycle) observed in response to a brief, single contraction. However, it is clear that there are additional mechanisms related to muscle activation that continue to cause and sustain vasodilatation for several more cardiac cycles after contraction. Additionally, the potential contribution of mechanical influences to the total contraction-induced hyperaemia appears greatest for low to moderate intensity single muscle contractions, and this contribution becomes less significant for sustained and repeated contractions. Nevertheless, this mechanically induced vasodilatation could serve as a feedforward mechanism to increase muscle blood flow at the onset of exercise, as well as in response to changes in contraction intensity, prior to alterations in local vasodilating substances that influence vascular tone.