Key result
L-NAME fails to improve pulmonary gas exchange or arterial hypoxemia during maximal exercise.
Why the study?
The role of endogenous nitric oxide production in exercise-induced arterial hypoxemia in horses was unclear.
Does nitric oxide synthase inhibition with L-NAME affect exercise-induced arterial hypoxemia in Thoroughbred horses?
RCT (n=7)
Random order crossover
Does nitric oxide synthase inhibition with L-NAME affect exercise-induced arterial hypoxemia in Thoroughbred horses?
Nitric oxide synthase inhibition does not affect pulmonary gas exchange in exercising horses but may limit performance by attenuating the rise in hemoglobin concentration and arterial oxygen content.
Answers are grounded in this paper and cite their sources.
Equine data warrant no human practice change; leaves open NO synthase inhibition effects on exercise hypoxemia.
Because sensitivity of equine pulmonary vasculature to endogenous as well as exogenous nitric oxide (NO) has been demonstrated, we examined whether endogenous NO production plays a role in exercise-induced arterial hypoxemia. We hypothesized that inhibition of NO synthase may alter the distribution of ventilation-perfusion mismatching, which may affect the exercise-induced arterial hypoxemia. Arterial blood-gas variables were examined in seven healthy, sound Thoroughbred horses at rest and during incremental exercise protocol leading to galloping at maximal heart rate without (control; placebo = saline) and with N(omega)-nitro-L-arginine methyl ester (L-NAME) administration (20 mg/kg iv). The experiments were carried out in random order, 7 days apart. At rest, L-NAME administration caused systemic hypertension, pulmonary hypertension, and bradycardia. During 120 s of galloping at maximal heart rate, significant arterial hypoxemia, desaturation of hemoglobin, hypercapnia, hyperthermia, and acidosis occurred in the control as well as in NO synthase inhibition experiments. However, statistically significant differences between the treatments were not found. In both treatments, exercise caused a significant rise in hemoglobin concentration, but the increment was significantly attenuated in the NO synthase inhibition experiments, and, therefore, arterial O(2) content (Ca(O(2))) increased to significantly lower values. These data suggest that, whereas L-NAME administration does not affect pulmonary gas exchange in exercising horses, it may affect splenic contraction, which via an attenuation of the rise in hemoglobin concentration and Ca(O(2)) may limit performance at higher workloads.
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Manohar et al. (2001) conducted an RCT in Healthy (n=7). N(omega)-nitro-L-arginine methyl ester (L-NAME) vs. Placebo (saline) was evaluated on Arterial blood-gas variables (arterial hypoxemia, desaturation of hemoglobin, hypercapnia, hyperthermia, and acidosis) during exercise (p=NS). Nitric oxide synthase inhibition with L-NAME did not significantly affect pulmonary gas exchange or exercise-induced arterial hypoxemia in Thoroughbred horses during maximal exercise.
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