-We investigated arm perfusion and metabolism during upper body exercise. Eight average, fit subjects and seven rowers, mean Ϯ SE maximal oxygen uptake (V O2 max) 157 Ϯ 7 and 223 Ϯ 14 ml O2⅐ kg Ϫ0.73 ⅐min Ϫ1 , respectively, performed incremental arm cranking to exhaustion. Arm blood flow (ABF) was measured with thermodilution and arm muscle mass was estimated by dual-energy X-ray absorptiometry. During maximal arm cranking, pulmonary V O2 was ϳ45% higher in the rowers compared with the untrained subjects and peak ABF was 6.44 Ϯ 0.40 and 4.55 Ϯ 0.26 l/min, respectively (P Ͻ 0.05). The arm muscle mass for the rowers and the untrained subjects was 3.5 Ϯ 0.4 and 3.3 Ϯ 0.1 kg, i.e., arm perfusion was 1.9 Ϯ 0.2 and 1.4 Ϯ 0.1 l blood⅐kg Ϫ1 ⅐min Ϫ1 , respectively (P Ͻ 0.05). The arteriovenous O2 difference was 156 Ϯ 7 and 120 Ϯ 8 ml/l, respectively, and arm V O2 was 0.98 Ϯ 0.08 and 0.60 Ϯ 0.04 l/min corresponding with 281 Ϯ 22 and 181 Ϯ 12 ml/kg, while arm O2 diffusional conductance was 49.9 Ϯ 4.3 and 18.6 Ϯ 3.2 ml⅐min Ϫ1 ⅐mmHg Ϫ1 , respectively (P Ͻ 0.05). Also, lactate release in the rowers was almost three times higher than in the untrained subjects (26.4 Ϯ 1.1 vs. 9.5 Ϯ 0.4 mmol/min, P Ͻ 0.05). The energy requirement of an ϳ50% larger arm work capacity after long-term arm endurance training is covered by an ϳ60% increase in aerobic metabolism and an almost tripling of the anaerobic capacity. arm exercise; blood pressure; lactate; oxygen diffusion; oxygen uptake CHRONIC ENDURANCE EXERCISE induces central and peripheral changes that enhance cardiac output and maximal oxygen uptake (V O 2 max ) (9). The important contribution of peripheral circulatory changes to this adaptive response is demonstrated by the hyperbolic relationship between V O 2 max and total vascular resistance both in cross-sectional and longitudinal studies (8). Because during maximal exercise ϳ85% of cardiac output is directed to the working skeletal muscles, it would be expected that the ϳ50% greater cardiac output after endurance training would result in an increase in muscle blood flow. Yet, although animal data support this assumption (19), it has been difficult to demonstrate a similar increase in muscle blood flow in trained humans (8). One explanation may be that a traininginduced increase in muscle mass makes an estimate of blood flow per unit of muscle relatively stable. Another consideration is that leg muscle blood flow has been evaluated after relatively short training periods (18, 23).In contrast to the legs, only specifically arm-trained subjects use their arms intensively. Thus arm cranking elicits a lower V O 2 max than leg exercise with a typical ratio between the two values of ϳ0.7 (26). Conversely, in arm-trained subjects, including rowers, V O 2 max during arm cranking reaches similar or even higher values than those obtained with their trained legs. During arm cranking at ϳ80% of V O 2 max , an arm blood flow (ABF) of ϳ2.4 l/min is reported in the untrained subjects (1) and ϳ3.8 l/min in arm-trained subjects (16), suggesting tha...