Heterogeneous blood flow distribution within single skeletal muscles in the rabbit: role of vasomotion, sympathetic nerve activity and effect of vasodilation

Ex vivo measures of muscle mitochondrial capacity reveal quantitative limits of oxygen delivery by the circulation during exercise

Muscle mitochondrial respiratory capacity measured ex vivo provides a physiological reference to assess cellular oxidative capacity as a component in the oxygen cascade in vivo. In this article, the magnitude of muscle blood flow and oxygen uptake during exercise involving a small-to-large fraction of the body mass will be discussed in relation to mitochondrial capacity measured ex vivo. These analyses reveal that as the mass of muscle engaged in exercise increases from one-leg knee extension, to 2-arm cranking, to 2-leg cycling and x-country skiing, the magnitude of blood flow and oxygen delivery decrease. Accordingly, a 2-fold higher oxygen delivery and oxygen uptake per unit muscle mass are seen in vivo during 1-leg exercise compared to 2-leg cycling indicating a significant limitation of the circulation during exercise with a large muscle mass. This analysis also reveals that mitochondrial capacity measured ex vivo underestimates the maximal in vivo oxygen uptake of muscle by up to ∼2-fold. This article is part of a Directed Issue entitled: Bioenergetic dysfunction, adaptation and therapy.

Spatial and temporal heterogeneity of regional pulmonary blood flow in piglets

Regional pulmonary blood flow (PBF) in adult animals varies over space and time, following a fractal pattern. We hypothesized that PBF would follow a fractal pattern in young animals. Five, two-week old piglets were sedated and mechanically ventilated. After stabilization, fluorescent microspheres were injected via the right atrium at baseline and then again at 5, 20, 20.5, 40 and 60 min. The lungs were subsequently excised, dried, inflated, and cored into 0.12-cm3 pieces (mean n=561+/-106 per animal) with the spatial coordinates recorded for each piece. Regional PBF was spatially and temporally heterogeneous with a spatial coefficient of variation of 43.3+/-7.9% and a temporal coefficient of variation of 14.3+/-0.4%. PBF followed a fractal pattern with a fractal dimension of 1.20+/-0.06 at 20 min, remaining stable throughout the experiment. PBF decreased with distance from the hilum but did not follow a lobar pattern. Temporal heterogeneity did not significantly increase with time but low flow regions demonstrated the greatest temporal variability throughout the study. Hence, PBF in young piglets was characterized both spatial and temporal heterogeneity.

Nitric oxide and prostaglandins influence local skeletal muscle blood flow during exercise in humans: coupling between local substrate uptake and blood flow

Synergic action of nitric oxide (NO) and prostaglandins (PG) in the regulation of muscle blood flow during exercise has been demonstrated. In the present study, we investigated whether these vasodilators also regulate local blood flow, flow heterogeneity, and glucose uptake within the exercising skeletal muscle. Skeletal muscle blood flow was measured in seven healthy young men using near-infrared spectroscopy and indocyanine green and muscle glucose uptake using positron emission tomography and 2-fluoro-2-deoxy-d-[18F]glucose without and with local blockade of NO and PG at rest and during one-legged dynamic knee-extension exercise. Local blockade was produced by infusing nitro-l-arginine methyl ester and indomethacin directly in the muscle via a microdialysis catheter. Blood flow and glucose uptake were measured in the region of blockade and in two additional regions of vastus lateralis muscle 1 and 4 cm away from the infusion of blockers. Local blockade during exercise at 25 and 40 watts significantly decreased blood flow in the infusion region and in the region 1 cm away from the site of infusion but not in the region 4 cm away. During exercise, muscle glucose uptake did not show any regional differences in response to blockade. These results show that NO and PG synergistically contribute to the local regulation of blood flow in skeletal muscle independently of muscle glucose uptake in healthy young men. Thus these vasodilators can play a role in regulating microvascular blood flow in localized regions of vastus lateralis muscle but do not influence regional glucose uptake. The findings suggest that local substrate uptake in skeletal muscle can be regulated independently of regional changes in blood flow.

Noninvasive assessment of sympathetic vasoconstriction in human and rodent skeletal muscle using near-infrared spectroscopy and Doppler ultrasound

The precise role of the sympathetic nervous system in the regulation of skeletal muscle blood flow during exercise has been challenging to define in humans, partly because of the limited techniques available for measuring blood flow in active muscle. Recent studies using near-infrared (NIR) spectroscopy to measure changes in tissue oxygenation have provided an alternative method to evaluate vasomotor responses in exercising muscle, but this approach has not been fully validated. In this study, we tested the hypothesis that sympathetic activation would evoke parallel changes in tissue oxygenation and blood flow in resting and exercising muscle. We simultaneously measured tissue oxygenation with NIR spectroscopy and blood flow with Doppler ultrasound in skeletal muscle of conscious humans ( n = 13) and anesthetized rats ( n = 9). In resting forearm of humans, reflex activation of sympathetic nerves with the use of lower body negative pressure produced graded decreases in tissue oxygenation and blood flow that were highly correlated ( r = 0.80, P < 0.0001). Similarly, in resting hindlimb of rats, electrical stimulation of sympathetic nerves produced graded decreases in tissue oxygenation and blood flow velocity that were highly correlated ( r = 0.93, P < 0.0001). During rhythmic muscle contraction, the decreases in tissue oxygenation and blood flow evoked by sympathetic activation were significantly attenuated ( P < 0.05 vs. rest) but remained highly correlated in both humans ( r = 0.80, P < 0.006) and rats ( r = 0.92, P < 0.0001). These data indicate that, during steady-state metabolic conditions, changes in tissue oxygenation can be used to reliably assess sympathetic vasoconstriction in both resting and exercising skeletal muscle.

Laser Doppler flowmetry mapping of cerebrocortical microflow: characteristics and limitations

The aim of this study was to quantitatively analyze the amount of methodological noise and the spatial and temporal variability of laser Doppler flowmetry (LDF) signals mapping cerebrocortical microflow. In an experimental setup with latex beads, the methodological LDF-signal variability was determined (coefficient of variation or CV(method)). The biological variability of the LDF signals was measured in animal experiments using 10 anesthetized rabbits. One stationary reference probe was used to assess temporal heterogeneity (CV(temp)) and a micromanipulator-driven scanning probe was used to assess spatial heterogeneity (CV(spat)) in a cortical area of 3.5 x 4.5 mm with 252 measurement points. CO(2) tests were used to modulate cerebrovascular resistance. CV(method) was found to be 4.94 +/- 1.7. The CV(temp) for the LDF-velocity signal was assessed to be 13.93 +/- 5.9 during normocapnia. Scanning of the brain surface with the scanning probe revealed a CV(spat) for LDF velocity of 65.0 +/- 16.2 during normocapnia. CO(2) modulation (hypocapnia --> normocapnia --> hypercapnia) of the cerebral resistance did not show a significant change in temporal heterogeneity (10.84 +/- 3.1 --> 13.93 +/- 5.9 --> 14.82 +/- 3.9), whereas spatial heterogeneity decreased significantly (81.31 +/- 12.0 --> 65.0 +/- 16.2 --> 54.04 +/- 21.8). Although the spatial and temporal variability of LDF signals evoked by cerebrocortical microflow is in the same range as with other methods and in other organs, LDF cerebrocortical mapping is restricted by the large temporal and spatial heterogeneity of the cerebrocortical vasculature. The definitions of sample volume, scanning step width, probe to brain surface distance, and average time per scanning point are critical concerning reliable LDF cerebrocortical mapping techniques.

Spatial distribution of nutritive and nonnutritive vascular routes in perfused rat hindlimb muscle using microspheres

Skeletal muscle appears to have two vascular flow routes, nutritive and nonnutritive, where the balance of flow is controlled by vasoconstrictors. In the present study, spatial distributions of the two flow routes in muscles of the perfused rat hindlimb were attempted using fluorescent microspheres (15 microm in diameter). Microspheres were injected during steady-state perfusion with norepinephrine (proposed recruiter of nutritive flow), serotonin (proposed recruiter of nonnutritive flow), or vehicle. The three-dimensional location of individual microspheres in representative muscles was determined using a Fluorescent Imaging CryoMicrotome. Norepinephrine and serotonin each increased perfusion pressure (P < 0.05) but stimulated and inhibited oxygen consumption (P < 0.05), respectively. The distribution of microspheres lodged in muscle was independent of the agent used. Spatial perfusion indices for norepinephrine, serotonin, and vehicle did not differ from each other. Similarly, there was no difference in these indices for a theoretical distribution where microspheres were deliberately positioned in muscle bundle capillaries or interfibrillar connective tissue vessels. We conclude that the nutritive and nonnutritive flow routes are distributed throughout muscle sections consistent with their locations in muscle bundle capillaries and interfibrillar connective tissue, respectively.

The 400 microsphere per piece "rule" does not apply to all blood flow studies

Microsphere experiments are useful in measuring regional organ perfusion as well as heterogeneity of blood flow within organs and correlation of perfusion between organ pieces at different time points. A 400 microspheres/piece "rule" is often used in planning experiments or to determine whether experiments are valid. This rule is based on the statement that 400 microspheres must lodge in a region for 95% confidence that the observed flow in the region is within 10% of the true flow. The 400 microspheres precision rule, however, only applies to measurements of perfusion to a single region or organ piece. Examples, simulations, and an animal experiment were carried out to show that good precision for measurements of heterogeneity and correlation can be obtained from many experiments with <400 microspheres/piece. Furthermore, methods were developed and tested for correcting the observed heterogeneity and correlation to remove the Poisson "noise" due to discrete microsphere measurements. The animal experiment shows adjusted values of heterogeneity and correlation that are in close agreement for measurements made with many or few microspheres/piece. Simulations demonstrate that the adjusted values are accurate for a variety of experiments with far fewer than 400 microspheres/piece. Thus the 400 microspheres rule does not apply to many experiments. A "rule of thumb" is that experiments with a total of at least 15,000 microspheres, for all pieces combined, are very likely to yield accurate estimates of heterogeneity. Experiments with a total of at least 25,000 microspheres are very likely to yield accurate estimates of correlation coefficients.

Vasoactive substances in the interstitium of contracting skeletal muscle examined by microdialysis

In the study of the regulation of skeletal muscle blood flow during exercise it is useful to obtain information regarding the concentrations of vasoactive substances in the muscle interstitium, a site where the compounds act on the vascular and skeletal muscle cells. The microdialysis technique is a useful tool for measuring interstitial substances in the muscle at rest and during exercise in human subjects, and the technique can also be used to study the effect of both systemic and local interventions in a specific area of an exercising muscle. Probe recovery, which represents the relative amount of a substance that is diffusing to the dialysis membrane, changes from rest to exercise and can be determined by the internal-standard technique which allows for a relatively high time resolution (min). Furthermore, the use of electrodes at the microdialysis outlet makes it possible to perform continuous measurements of interstitial substances. The present review gives examples of how the microdialysis technique has been applied to study potentially important vasodilators such as adenosine, NO and K+ in human skeletal muscles and highlights areas for future research to establish the functional importance of these compounds.

Muscle interstitial glucose and lactate levels during dynamic exercise in humans determined by microdialysis

The purpose of the present study was to use the microdialysis technique to determine skeletal muscle interstitial glucose and lactate concentrations during dynamic incremental exercise in humans. Microdialysis probes were inserted into the vastus lateralis muscle, and subjects performed knee extensor exercise at workloads of 10, 20, 30, 40, and 50 W. The in vivo probe recoveries determined at rest by the internal reference method for glucose and lactate were 28.7 +/- 2.5 and 32.0 +/- 2.7%, respectively. As exercise intensity increased, probe recovery also increased, and at the highest workload probe recovery for glucose (61.0 +/- 3.9%) and lactate (66. 3 +/- 3.6%) had more than doubled. At rest the interstitial glucose concentration (3.5 +/- 0.2 mM) was lower than both the arterial (5.6 +/- 0.2 mM) and venous (5.3 +/- 0.3 mM) plasma water glucose levels. The interstitial glucose levels remained lower (P < 0.05) than the arterial and venous plasma water glucose concentrations during exercise at all intensities and at 10, 20, 30, and 50 W, respectively. At rest the interstitial lactate concentration (2.5 +/- 0.2 mM) was higher (P < 0.05) than both the arterial (0.9 +/- 0. 2 mM) and venous (1.1 +/- 0.2 mM) plasma water lactate levels. This relationship was maintained (P < 0.05) during exercise at workloads of 10, 20, and 30 W. These data suggest that interstitial glucose delivery at rest is flow limited and that during exercise changes in the interstitial concentrations of glucose and lactate mirror the changes observed in the venous plasma water compartments. Furthermore, skeletal muscle contraction results in an increase in the diffusion coefficient of glucose and lactate within the interstitial space as reflected by an elevation in probe recovery during exercise.

Microdialysis ethanol removal reflects probe recovery rather than local blood flow in skeletal muscle

The present study compared the microdialysis ethanol outflow-inflow technique for estimating blood flow (BF) in skeletal muscle of humans with measurements by Doppler ultrasound of femoral artery inflow to the limb (BFFA). The microdialysis probes were inserted in the vastus lateralis muscle and perfused with a Ringer acetate solution containing ethanol, [2-3H]adenosine (Ado), and D-[14C(U)]glucose. BFFA at rest increased from 0.16 +/- 0.02 to 1.80 +/- 0.26 and 4.86 +/- 0.53 l/min with femoral artery infusion of Ado (AdoFA,i) at 125 and 1,000 microg . min-1 . l-1 thigh volume (low dose and high dose, respectively; P < 0.05) and to 3.79 +/- 0.37 and 6.13 +/- 0.65 l/min during one-legged, dynamic, thigh muscle exercise without and with high AdoFA,i, respectively (P < 0.05). The ethanol outflow-to-inflow ratio (38.3 +/- 2.3%) and the probe recoveries (PR) for [2-3H]Ado (35.4 +/- 1.6%) and for D-[14C(U)]glucose (15.9 +/- 1.1%) did not change with AdoFA,i at rest (P = not significant). During exercise without and with AdoFA,i, the ethanol outflow-to-inflow ratio decreased (P < 0.05) to a similar level of 17.5 +/- 3.4 and 20.6 +/- 3.2%, respectively (P = not significant), respectively, while the PR increased (P < 0.05) to a similar level (P = not significant) of 55.8 +/- 2.8 and 61.2 +/- 2. 5% for [2-3H]Ado and to 42.8 +/- 3.9 and 45.2 +/- 5.1% for D-[14C(U)]glucose. Whereas the ethanol outflow-to-inflow ratio and PR correlated inversely and positively, respectively, to the changes in BF during muscular contractions, neither of the ratio nor PR correlated to the AdoFA,i-induced BF increase. Thus the ethanol outflow-to-inflow ratio does not represent skeletal muscle BF but rather contraction-induced changes in molecular transport in the interstitium or over the microdialysis membrane.

Preserved relative dispersion but blunted stimulation of mean flow, absolute dispersion, and blood volume by insulin in skeletal muscle of patients with essential hypertension

BACKGROUND

We examined the integrity of the effects of insulin on mean muscle blood flow, flow heterogeneity, and blood volume in essential hypertension.

METHODS AND RESULTS

Positron emission tomography, combined with [15O]H2O and [15O]CO as tracers for direct measurement of blood flow and volume in skeletal muscle, and a new bayesian iterative reconstruction algorithm allowing pixel-by-pixel quantitation of blood flow and flow dispersion, were used. Measurements were performed basally after an overnight fast and under normoglycemic hyperinsulinemic conditions in 11 newly diagnosed, untreated mildly hypertensive men (age, 35 +/- 1 years; body mass index, 25.2 +/- 0.4 kg/m2, blood pressure 141 +/- 4/96 +/- 2 mm Hg, mean +/- SE) and 11 matched normotensive men. Insulin-stimulated whole body glucose uptake was significantly decreased in the hypertensive men (41 +/- 4 mumol/kg per minute) compared with the normotensive (59 +/- 4 mumol/kg per minute, P < 0.005) men. Mean blood flow in skeletal muscle was significantly lower in the hypertensive than the normal subjects basally (1.7 +/- 0.2 versus 2.7 +/- 0.4 mL/0.1 kg per minute, P < 0.05) and during hyperinsulinemia (2.3 +/- 0.2 versus 4.2 +/- 0.8, P < 0.05). The flow response to insulin (0.6 +/- 0.2 versus 1.9 +/- 0.5 mL/0.1 kg per minute, hypertensive versus normal subjects, P < 0.05) was also significantly blunted. Muscle blood volume was significantly lower in the hypertensive than in the normal subjects, both basally (3.0 +/- 0.2 versus 3.5 +/- 0.2 mL/0.1 kg, P < 0.05) and during hyperinsulinemia (3.1 +/- 0.2 versus 4.0 +/- 0.2 mL/0.1 kg muscle, P < 0.02). The increase in muscle blood volume by insulin was significant in the normal (P < 0.05) but not the hypertensive subjects. Regional pixel-by-pixel analysis within femoral muscles revealed significant spatial heterogeneity of blood flow. Insulin increased absolute dispersion of blood flow significantly more in the normal subjects than in the hypertensive subjects (P < 0.05).

CONCLUSIONS

True flow heterogeneity, as judged from the coefficients of variation (relative dispersion), was comparable between the groups basally and during hyperinsulinemia. We conclude that mean flow, its absolute dispersion, and blood volume exhibit insulin resistance in patients with essential hypertension.

Intact insulin stimulation of skeletal muscle blood flow, its heterogeneity and redistribution, but not of glucose uptake in non-insulin-dependent diabetes mellitus

We tested the hypothesis that defects in insulin stimulation of skeletal muscle blood flow, flow dispersion, and coupling between flow and glucose uptake contribute to insulin resistance of glucose uptake in non-insulin-dependent diabetes mellitus (NIDDM). We used positron emission tomography combined with [15O]H2O and [18F]-2-deoxy--glucose and a Bayesian iterative reconstruction algorithm to quantitate mean muscle blood flow, flow heterogeneity, and their relationship to glucose uptake under normoglycemic hyperinsulinemic conditions in 10 men with NIDDM (HbA1c 8.1+/-0.5%, age 43+/-2 yr, BMI 27.3+/-0.7 kg/m2) and in 7 matched normal men. In patients with NIDDM, rates of whole body (35+/-3 vs. 44+/-3 micromol/kg body weight.min, P < 0.05) and femoral muscle (71+/-6 vs. 96+/-7 micromol/kg muscle.min, P < 0.02) glucose uptake were significantly decreased. Insulin increased mean muscle blood flow similarly in both groups, from 1.9+/-0.3 to 2.8+/-0.4 ml/100 g muscle.min in the patients with NIDDM, P < 0.01, and from 2.3+/-0.3 to 3.0+/-0.3 ml/100 g muscle.min in the normal subjects, P < 0.02. Pixel-by-pixel analysis of flow images revealed marked spatial heterogeneity of blood flow. In both groups, insulin increased absolute but not relative dispersion of flow, and insulin-stimulated but not basal blood flow colocalized with glucose uptake. These data provide the first evidence for physiological flow heterogeneity in human skeletal muscle, and demonstrate that insulin increases absolute but not relative dispersion of flow. Furthermore, insulin redirects flow to areas where it stimulates glucose uptake. In patients with NIDDM, these novel actions of insulin are intact, implying that muscle insulin resistance can be attributed to impaired cellular glucose uptake.

The exercise pressor response to sustained handgrip does not augment blood flow in the contracting forearm skeletal muscle

Previous studies have advanced the concept that during sustained handgrip (SHG) reflex increases in blood pressure are able to partially offset increases in tissue pressure and thus effectively maintain increases in muscle blood flow during mild to moderate levels of sustained handgrip. However, this concept is based upon measurements of blood flow to the entire forearm. The aim of this study was to evaluate this concept by simultaneously measuring time-dependent changes in systemic arterial pressure and blood flow in an active muscle during the actual period of exercise. To accomplish this aim, we measured 133Xenon washout from the extensor carpi radialis longus muscle over 3 min of SHG at 15, 30 and 45% of maximal voluntary contraction (MVC). During sustained handgrip at 15% MVC, muscle blood flow increased more than 20 fold from rest to exercise (P < 0.05), even though mean arterial pressure increased by only 12 +/- 4 mmHg. This large exercise-induced hyperaemia was abolished during SHG at both 30 and 45% MVC, despite large and progressive increases in mean arterial pressure of 29 +/- 3 and 54 +/- 5 mmHg, respectively. We conclude that at levels of handgrip above 15% MVC blood pressure ceases to be an important determinant of blood flow in the active skeletal muscle. Importantly, the increases in forearm blood flow that have been reported previously with such levels of static handgrip do not appear to be directed to the most active muscle.

Local blood flow is not linked to lactate within single rabbit skeletal muscles

A marked regional distribution in blood flow within single skeletal muscles on a non-microvascular level, i.e. at the level of large arterioles or small arteries, is present in dog, cat and rabbit. The mechanism for this perfusion pattern is not known. The goal of the present study was to see if regional blood flow was correlated to regional lactate metabolism. Anesthetized rabbits were studied. Blood flow to 0.25 g muscle samples was measured with microspheres whereas lactate content and lactate dehydrogenase activity were determined in extracts of these samples. No correlation was detected between regional blood flow and regional lactate or lactate dehydrogenase either at rest or during exercise hyperemia. Expressed as the coefficient of variation (CVc), regional blood flow showed a marked scatter, the CVc ranged from 0.32 to 0.35. The corresponding CVc for both lactate and lactate dehydrogenase activity ranged from 0.16 to 0.19. It is concluded that regional blood flow is not correlated to regional lactate metabolism. The regional distribution in blood flow was markedly more uneven than that for lactate content and for lactate dehydrogenase activity.

Bite-force development, metabolic and circulatory response to electrical stimulation in the canine and porcine masseter muscles

The development of fatigue was investigated by electrical stimulation in 15 domestic pigs (1 yr old, 70-90 kg body weight) and seven adult dogs (3 yr old, 45 kg body weight). After anaesthesia, silver electrodes were implanted in the anterior and posterior parts of the right masseter muscles. The contralateral muscle was used as control. The bite force was measured. Muscle biopsies were obtained from the anterior, central and posterior parts, and were immediately frozen in liquid nitrogen. A fluorometrical analysis by enzymatic methods for glycogen, glucose, creatine phosphate, NAD, NADH, lactate and pyruvate was made. Blood flow was measured by 133Xe wash-out; oxygen consumption was monitored with an oxygen electrode. The porcine masseter was continuously stimulated for 60 min (100 V, 4 Hz and 2 ms). The canine masseter was intermittently stimulated (100 V, 20 Hz and 2 ms). The contraction was repeated four times, with a 10-min rest between. The porcine masseter could sustain longer endurance times than the canine masseter, which was easily fatigued. A marked substrate depletion was evident. The precontractional contents of glycogen, glucose and creatine phosphate were reduced. Lactate accumulation was evident (2-4 times more in the porcine and 4-8 times more in the canine masseter). The NADH concentration increased and the NAD content decreased. Blood-flow impairment (80% reduction in the dog, 60% in the pig) was observed. After the contraction phase, there was a hyperaemia (58% elevation of blood flow in the pig masseter, 45% in the canine). The oxygen tension followed in magnitude and time the blood-flow changes. These circulatory variables returned to normal after recovery. The high degree of substrate depletion, blood-flow impairment and a simultaneous decrease in oxygen transport to the contracted muscle, in combination with a prominent lactate accumulation, may induce a decrease in bite-force production.

Evidence for long-term fluctuations in regional blood flow within the rabbit left ventricle

The regional distribution of coronary perfusion within the left ventricle is markedly heterogenous. The perfusion pattern is composed of both spatial and temporal variations in perfusion among single myocardial samples. Previous investigators have mostly studied short-term (< 1 min) temporal variability. The aim of this study was to quantify long-term fluctuations in perfusion to single samples within the rabbit left ventricle. Coronary perfusion was estimated from the deposition of microspheres in myocardial samples (range 32-96 mg). Two batches of microspheres were infused either simultaneously or sequentially over specified periods of time. The paired values for regional perfusion were compared and Kendalls correlation coefficient (tau) calculated. The assumption being that the lower tau, the higher degree of temporal perfusion variability was present. The tau for paired values of regional myocardial perfusion based on two sequential infusions lasting either 10 s, 5, 10 or 30 min, averaged 0.40, 0.55, 0.80 and 0.80, respectively. No difference was detected between awake and anaesthetized animals. The tau for two simultaneous infusions averaged 0.95 irrespective of the duration of the infusion, indicating negligible methodological error. The coefficient of variation for spatial perfusion heterogeneity ranged from 0.3 to 0.4 irrespective of the infusion duration. The findings suggest that regional coronary vasomotion is characterized by a wide range of cycle times, some of which have cycle times of more than 30-min duration. Although part of the regional perfusion heterogeneity was due to long-term fluctuations in perfusion, temporal variations with cycle times less than 5 and 10 min, respectively, were more prominent.

Uneven perfusion within single cat muscles: nitric oxide and citrate synthase play no role

There is an unexplained, marked regional heterogeneity in perfusion within single skeletal muscles both in dogs and rabbits. We asked if a similar distribution of perfusion was present within cat muscles. If present, we wanted to assess the possible roles of nitric oxide (NO) mediated vasodilation and citrate synthase (CS) activity for the regulation of this perfusion pattern. Perfusion was determined in 0.25 g regions within the gastrocnemius muscles by trapping of microspheres. We studied awake or anesthetized cats before and during inhibition of NO-formation using N-monomethyl-L-arginine. The CS activity was determined in homogenates of these regions. The coefficient of variation corrected for the Poisson distribution of microspheres (CVc) for the regional perfusion averaged 0.39. Despite a 25% reduction in perfusion to the whole muscles as compared to control, the uneven distribution of perfusion was not affected by blocking NO formation. Regional perfusion was not correlated to regional CS activity. Even if the regional distribution of CS activity also showed a scatter, mean coefficient of variation corrected for methodological error = 0.20, it was markedly less than that for perfusion. We conclude that neither NO vasodilation nor CS activity play an important role in the regulation of the regional perfusion pattern within single cat muscles.

Modeling of oxygen transport to skeletal muscle: blood flow distribution, shunt, and diffusion

By injection of embolizing microspheres, by local radioactive xenon clearance and by inert gas washout in resting and stimulated gastrocnemius dog preparation, experimental evidence for unequal blood flow distribution and for shunt flow has been provided. Model calculations show that in some respect unequal blood flow and shunt produce effects predicted for a homogeneous model with diffusion limitation of O2 supply. This finding must be taken into account when the role of diffusion limitation to O2 supply is to be ascertained.

Methodological error and spatial variability of organ blood flow measurements using radiolabeled microspheres

The quantitative analysis of the spatial variability of organ blood flow by means of radiolabeled microspheres (MS) requires that the methodological variability ("error") of the technique (RDmeth.) is known in each individual organ. Therefore, RDmeth. was quantified (eight to nine nuclides) in 6941 tissue samples from 13 organs of three anesthetized dogs, and the relative importance of errors originating from both the stochastic nature of MS distribution (RDtheo.) and the process of quantitation of MS radioactivity (RDcounting) was assessed under varying conditions (high/low specific MS activity (SAMS); inaccurate separation of gamma spectra; large sample size). At "minimized" methodological error (experiment 2), RDmeth. of samples trapping approximately 375 MS/nuclide was 5.8% and only slightly exceeded RDtheo. (5%). RDmeth. varied in the range 2.7-7.8% in individual organs and contributed little (3.5%) to the organs' observed spatial variability of flow. In contrast, RDmeth.--due to increased RDcounting--considerably exceeded RDtheo. when SAMS was low (experiment 3), overlap of two nuclides' main photopeaks was critical (experiment 1), or counting geometry was inappropriate (pulmonary tissue samples). At the same time, the contribution of RDmeth. to spatial flow variability rose to 7.9% (experiment 3), 26.9% (experiment 1), and 15-23% (lungs). Completely artifactual measurements, as indicated by an extremely high RDmeth. of sample flow, were rarely observed (less than 0.1%). In general, our data suggest that blood flow can be measured reproducibly and with low methodological error using up to 8 nuclides, RDmeth. does not essentially contribute to the observed spatial variability of organ blood flow, and, hence, organ flow variability may be accurately quantified using the MS technique. However, if sources of error as indicated above are present, the practice of using RDtheo. as a measure of RDmeth. (thereby neglecting RDcounting) may notably underestimate true MS error and result in an overestimation of spatial heterogeneity of organ blood flow. RDmeth., therefore, should be quantified separately in each region of interest prior to the onset of a new study.

Regional distributions of blood flow and tissue uptake rates of vitamin B12 and albumin within single rabbit skeletal muscles

The mechanism underlying the marked regional variations in blood flow within single skeletal muscles has not been identified. The present investigation was prompted by previous data pointing to a regional distribution of the number of perfused vessels as one possible determinant for the heterogeneous perfusion pattern. We examined this possibility by assessing the regional tissue uptake rates of vitamin B12 and albumin assuming that these are related to the number of perfused vessels. This is the first study that has included simultaneous measurements of regional blood flow and of regional tissue uptake rates of vitamin B12 and albumin within single skeletal muscles in the intact animal. The microsphere method was adopted to measure regional blood flow in 0.25 g muscle regions in awake and in anaesthetized rabbits. Various tracers were used to assess the regional distributions of tissue uptake rates and of vascular and interstitial volumes. Albeit displaying a marked regional heterogeneity, neither the tissue uptake rate of vitamin B12 nor that of albumin were correlated to regional blood flow (P less than 0.05) at rest (awake or anaesthetized rabbits) or during exercise hyperaemia (anaesthetized). At rest, but not during exercise, the distributions of regional tissue uptake rates of the two tracers showed a striking bimodal pattern. Vascular and interstitial volumes showed minimal interregional variations. The lack of correlation between regional blood flow and tissue uptake rates and the minute interregional variation in vascular volume, argue against variations in the number of perfused vessels as the explanation for the regional heterogeneity in blood flow.

Oxygen supply and uptake in tissue models with unequal distribution of blood flow and shunt

The effects of unequal distribution of blood flow on O2 uptake are studied on a model composed of 3 tissues compartments with blood flow/O2 requirement ratios in the relation 9:3:1 (unequal blood flow model), a model with 33% shunt blood flow (shunt model), and a single compartment model without shunt (reference model). Diffusion limitation is assumed to be absent. Total blood flow (Q), arterial O2 content (CaO2) and O2 requirement of tissue are varied singly, and the resulting (mixed) venous O2 content (CvO2) and O2 uptake are calculated. In the reference model, CvO2 become zero, and O2 uptake starts falling below the O2 requirement, as soon as the O2 delivery (Q.CaO2) becomes smaller than the O2 requirement. In contrast, in the unequal blood flow model, decrease in the ratio O2 uptake/O2 requirement and in CvO2 sets in earlier, and proceeds more gradually, with decreasing Q or CaO2 or increasing O2 requirement; this is, because O2 delivery limitation sets in sequentially in the compartments, starting with the least perfused compartment. The shunt model behaves similarly to the reference model if Q or O2 requirement is varied, and to the unequal blood flow model if CaO2 is varied. Some features such as the parallel fall of O2 uptake and of CVO2 with decreasing CaO2, common to the unequal blood flow and shunt models, are similar to expected effects of diffusion limitation. Therefore, when the influence of diffusion limitation on tissue O2 supply is to be investigated quantitatively, the effects of a possible unequal distribution of blood flow must be taken into account.

The apparent absence of serotonin-mediated vascular thermogenesis in perfused rat hindlimb may result from vascular shunting

Vasoconstriction by norepinephrine, angiotensin II and vasopressin in the constant-flow perfused rat hindlimb is associated with increased oxygen uptake and has given rise to the concept of vascular thermogenesis. In the present study serotonin (5-hydroxytryptamine, 5HT) was found to inhibit oxygen uptake by up to 40% in a dose dependent manner whilst inducing vasoconstriction in this model, whereas norepinephrine increased oxygen consumption by up to 100% during vasoconstriction. This contrasted with the perfused isolated rat mesenteric artery arcade in which serotonin stimulated oxygen uptake by up to 130% in association with vasoconstriction in a dose dependent manner similar to the previously described norepinephrine induced vascular thermogenesis in this arterial preparation. In both perfusion systems, changes in pressure and oxygen uptake mediated by serotonin were completely blocked by ketanserin. These results and evidence from dye washout studies suggest that serotonin-mediated vascular thermogenesis, if it occurs in the constant-flow hindlimb, is masked by vascular shunting.

The distribution of blood flow and glucose uptake within single skeletal muscles in the awake rabbit

We have previously described a substantial regional heterogeneity both in blood flow and in glucose uptake within single skeletal muscles in anaesthetized rabbits. These heterogeneities could be related to effects of anaesthesia. The main goal of the present study was therefore to study regional muscle blood flow and muscle glucose uptake in awake rabbits. We used the microsphere method and the deoxyglucose technique for assessment of regional blood flow and regional glucose uptake respectively. The measurements were performed in 0.25-g regions from hind leg muscles. Some rabbits were first studied while awake and then during anaesthesia. Others were studied while either awake or anaesthetized. The degree of regional heterogeneity in blood flow and in glucose uptake was similar in awake and anaesthetized rabbits. Both temporal and spatial heterogeneity in blood flow were present. Evidence was found for vasomotion with a cycle time exceeding 45 min in awake rabbits. This perfusion pattern was similar in rabbits in which either the motor or sympathetic vasomotor nerves or both had been blocked. We conclude that regional perfusion and glucose uptake within single muscles are also markedly heterogeneous in awake rabbits. Regional, non-synchronized fluctuations in blood flow with a long cycle time seem to be an important part of this perfusion heterogeneity.

Unequal distribution of blood flow in exercising muscle of the dog

The incomplete O2 extraction in stimulated muscle preparations as well as in exercising muscles has been attributed to diffusion limitation. In particular, the constancy of the ratio maximum O2 uptake-venous PO2 with varied O2 supply conditions is in agreement with predictions on the basis of simple perfusion-diffusion models. But several methods (inert gas washout, local xenon clearance, microsphere embolization) have revealed presence of a considerable degree of inhomogeneity of muscle blood flow and shunting both in supramaximally stimulated and in naturally exercising muscle. This inhomogeneity must be taken into account when estimating diffusion limitation in O2 supply.