The primary focus of this review is to discuss the importance of vascular smooth muscle function in mechanisms underlying exercise hyperemia in skeletal muscle. Important features of exercise hyperemia are presented and include: 1) the large magnitude of increase in blood flow, 2) the pattern of increased blood flow within and among skeletal muscle during exercise, 3) exercise hyperemia results from increases in vascular conductance produced by relaxation of vascular smooth muscle, 4) the increased blood flow is linked to the oxidative metabolism of the muscle, and 5) the increased blood flow occurs very rapidly with the initiation of exercise. A prevailing theme throughout this review is that vascular smooth muscle is a primary integrator of vasoactive signals that, in turn, regulate vascular resistance and muscle blood flow. Signal transduction pathways involved in vascular smooth muscle contraction and relaxation are discussed, with particular emphasis on the role of multiple and redundant signaling pathways for initiating a given contractile/relaxation response. We emphasize the concept that exercise hyperemia is a local phenomenon and that, during maximal exercise when most signals for vasoconstriction are still present, three primary control mechanisms are thought to regulate vasodilation and subsequent increases in vascular conductance: myogenic vascular control, metabolic vascular control, and endothelium-mediated vascular control. Experimental paradigms to test the relative importance of the predominant mechanisms thought to underlie exercise hyperemia are discussed and evaluated in light of the multiple and redundant control systems now known to contribute to control of blood flow in striated muscle tissue.
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