Animal studies suggest that the inhibition of nitric oxide synthase (NOS) affects blood flow differently in different skeletal muscles according to their muscle fibre type composition (oxidative vs glycolytic). Quadriceps femoris (QF) muscle consists of four different muscle parts: vastus intermedius (VI), rectus femoris (RF), vastus medialis (VM), and vastus lateralis (VL) of which VI is located deep within the muscle group and is generally regarded to consist mostly of oxidative muscle fibres.
We studied the effect of NOS inhibition on blood flow in these four different muscles by positron emission tomography in eight young healthy men at rest and during one-leg dynamic exercise, with and without combined blockade with prostaglandins.
At rest blood flow in the VI (2.6 ± 1.1 ml/100 g/min) was significantly higher than in VL (1.9 ± 0.6 ml/100 g/min, p = 0.015) and RF (1.7 ± 0.6 ml/100 g/min, p = 0.0015), but comparable to VM (2.4 ± 1.1 ml/100 g/min). NOS inhibition alone or with prostaglandins reduced blood flow by almost 50% (p < 0.001), but decrements were similar in all four muscles (drug × muscle interaction, p = 0.43). During exercise blood flow was also the highest in VI (45.4 ± 5.5 ml/100 g/min) and higher compared to VL (35.0 ± 5.5 ml/100 g/min), RF (38.4 ± 7.4 ml/100 g/min), and VM (36.2 ± 6.8 ml/100 g/min). NOS inhibition alone did not reduce exercise hyperemia (p = 0.51), but combined NOS and prostaglandin inhibition reduced blood flow during exercise (p = 0.002), similarly in all muscles (drug × muscle interaction, p = 0.99).
NOS inhibition, with or without prostaglandins inhibition, affects blood flow similarly in different human QF muscles both at rest and during low-to-moderate intensity exercise.
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Nitric oxide synthase
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The study was conducted within the Finnish Centre of Excellence in Molecular Imaging in Cardiovascular and Metabolic Research—supported by the Academy of Finland, University of Turku, Turku University Hospital and Abo Academy. Authors want to thank the contribution of the personnel of the Turku PET Centre for their excellent assistance during the study. The study was financially supported by the Ministry of Education of State of Finland, Academy of Finland, the Finnish Cultural Foundation and its South-Western Fund, the Finnish Sport Research Foundation, the Finnish Foundation for Cardiovascular Research, the Finnish Diabetes Research Foundation, Turku University Hospital (EVO funding), Novo Nordisk Foundation and the Danish Medical Research Council.
Conflict of interest
None of the authors had personal or financial conflict of interest.
Communicated by: Keith Phillip George
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Heinonen, I., Saltin, B., Hellsten, Y. et al. The effect of nitric oxide synthase inhibition with and without inhibition of prostaglandins on blood flow in different human skeletal muscles. Eur J Appl Physiol 117, 1175–1180 (2017). https://doi.org/10.1007/s00421-017-3604-2
- Muscle fibres
- Blood flow
- Nitric oxide