KIR channel activation contributes to onset and steady-state exercise hyperemia in humans

We tested the hypothesis that activation of inwardly rectifying potassium (KIR) channels and Na+-K+-ATPase, two pathways that lead to hyperpolarization of vascular cells, contributes to both the onset and steady-state hyperemic response to exercise. We also determined whether after inhibiting these pathways nitric oxide (NO) and prostaglandins (PGs) are involved in the hyperemic response. Forearm blood flow (FBF; Doppler ultrasound) was determined during rhythmic handgrip exercise at 10% maximal voluntary contraction for 5 min in the following conditions: control [saline; trial 1 (T1)]; with combined inhibition of KIR channels and Na+-K+-ATPase alone [via barium chloride (BaCl2) and ouabain, respectively; trial 2(T2)]; and with additional combined nitric oxide synthase (NG-monomethyl-l-arginine) and cyclooxygenase inhibition [ketorolac; trial 3 (T3)]. In T2, the total hyperemic responses were attenuated ∼50% from control (P < 0.05) at exercise onset, and there was minimal further effect in T3 (protocol 1; n= 11). In protocol 2 (n = 8), steady-state FBF was significantly reduced during T2 vs. T1 (133 ± 15 vs. 167 ± 17 ml/min; Δ from control: −20 ± 3%; P < 0.05) and further reduced during T3 (120 ± 15 ml/min; −29 ± 3%; P < 0.05 vs. T2). In protocol 3 (n = 8), BaCl2 alone reduced FBF during onset (∼50%) and steady-state exercise (∼30%) as observed in protocols 1 and 2, respectively, and addition of ouabain had no further impact. Our data implicate activation of KIR channels as a novel contributing pathway to exercise hyperemia in humans.