FACTORS DETERMINING DELAYED PEAK FLOW IN CANINE MYOCARDIAL REACTIVE HYPEREMIA

Summary: It has been suggested that delayed restoration of flow to the deeper layers of the myocardium is responsible for the gradual rise to peak flow rate characteristic of myocardial hyperaemia (RH). The distribution of coronary flow during RH was studied by injecting radiomicrospheres into the left atrium of open chest dog preparations just prior to the end of a 15 s occlusion of the left circumflex branch. The artery was then reoccluded after 1, 2, or 4 s of RH. Myocardium perfused by the left anterior decending branch served as a control; the ratio of endocardial to epicardial (end/epi) perfusion in this bed averaged 1.14. During coronary occlusion and during the first second of RH the end/epi ratio in the hyperaemic zone averaged 50% of control, but rose progressively to equal control at the time of peak flow. Although evanescent subendocardial ischaemia may contribute to the gradual rise to peak flow rate it cannot by itself account for the time course of this response.