Evaluating metabolic changes in heart disease by magnetic resonance spectroscopy

Magnetic resonance spectroscopy (MRS) is a versatile and powerful tool for the non invasive study of cardiac metabolism and can be used to measure myocardial concentrations of many different metabolites. The most widely studied nucleus, phosphorus-31, allows for the detection of phosphocreatine, ATP, intracellular pH, and flux through the creatine kinase reaction. Carbon-13-MRS has a low sensitivity, but several metabolites can be measured to facilitate study of substrate utilization and flux. Finally, hydrogen-1 (proton)-MRS can be used to study myocardial oxygenation and creatine concentrations. Here, we give a brief overview of the different applications of cardiac MRS and the pathophysiological insights derived from such studies.