Matching blood flow to myocardial energy demand is vital for heart performance and recovery following ischemia. The molecular mechanisms responsible for transduction of myocardial energetic signals into reactive vasodilatation are, however, elusive. Adenylate kinase, associated with AMP signaling, is a sensitive reporter of the cellular energy state, yet the contribution of this phosphotransfer system in coupling myocardial metabolism with coronary flow has not been explored. Here, knock out of the major adenylate kinase isoform, AK1, disrupted the synchrony between inorganic phosphate P i turnover at ATP-consuming sites and ␥-ATP exchange at ATP synthesis sites, as revealed by 18 O-assisted 31 P NMR. This reduced energetic signal communication in the post-ischemic heart. AK1 gene deletion blunted vascular adenylate kinase phosphotransfer, compromised the contractility-coronary flow relationship, and precipitated inadequate coronary reflow following ischemiareperfusion. Deficit in adenylate kinase activity abrogated AMP signal generation and reduced the vascular adenylate kinase/ creatine kinase activity ratio essential for the response of metabolic sensors. The sarcolemma-associated splice variant AK1 facilitated adenosine production, a function lost in the absence of adenylate kinase activity. Adenosine treatment bypassed AK1 deficiency and restored post-ischemic flow to wild-type levels, achieving phenotype rescue. AK1 phosphotransfer thus transduces stress signals into adequate vascular response, providing linkage between cell bioenergetics and coronary flow.Coronary blood flow is tightly linked to myocardial oxygen consumption securing adequate oxygenation and nutrient delivery and preventing underperfusion (1-4). Mismatch between myocardial blood supply and energy metabolism precipitates heart dysfunction, leading to aberrant force-frequency relationships in acute coronary and chronic metabolic syndromes (4 -7). The no-reflow phenomenon, observed after vascular reperfusion, precipitates poor outcome (8). Despite advances made in elucidating components that regulate vascular tone, the intimate mechanisms integrating metabolic signals and securing adequate vasodilatation under stress remain partially understood (4, 9 -13).Regulation of vascular tone involves several effectors, including ATP-sensitive potassium (K ATP ) channels, adenosine and purinergic signaling, AMP-activated protein kinase (AMPK), 3 nitric oxide (NO), and neurohormonal factors (1-4, 9 -13). Intra-and extracellular nucleotide-mediated signaling pathways catalyzed by phosphotransfer enzymes may provide linkage between these otherwise distinct systems (14 -16). In particular, adenylate kinase phosphotransfer couples with K ATP channels, facilitating decoding of metabolic signals critical in adjusting excitability-dependent functions in response to demand (17, 19 -21). Adenylate kinase, with a unique property to catalyze the reaction 2ADP 7 ATPϩAMP, is a sensitive reporter of the cellular energy state, translating small changes in the ATP/AD...