A mathematical model of coronary capillary flow demonstrates regional differences in flow determinants, highlighting the role of intramyocardial pumping in the subendocardium.
Model predictions of regional capillary flow warrant experimental validation; leaves open clinical translation.
The coronary capillary flow is analyzed theoretically based on continuum mechanics. The capillary is a long, elastic, and permeable vessel loaded externally by tissue pressure, and it is subject to possible periodic length changes, together with adjacent myocytes. Capillary flow is driven by arteriolar-venular pressure difference. Ultrafiltration due to transmural hydrostatic and osmotic gradients is included, and consideration of mass conservation leads to a nonlinear flow equation. The results show that under physiological conditions ultrafiltration is of minor importance, and the analysis predicts regional differences in capillary flow. In regions with high tissue pressure (subendocardium), capillaries undergo significant periodic volume changes, giving rise to intramyocardial pumping. In those regions, capillary wall elasticity is of major importance. In regions with low tissue pressure (subepicardium), the possible periodic capillary length changes are predominant. The predicted flow patterns are in good qualitative agreement with measured epicardial phasic flow. In conclusion, the methodological advantage of a distributive analysis is demonstrated by its ability to elucidate and evaluate the role of flow determinants and their complex interactions.
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Fibich et al. (1993) studied this question.
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