Current status of cardiac MR spectroscopy Aparna Singhal a , Kalyanam Shivkumar a,b , Amir Huda a,c , M. Albert Thomas a, * a Department of Radiological Sciences, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095-1721, USA b Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095, USA c Department of Physics, California State University, Fresno, CA 93740, USA article info Article history: Received 22 July 2008 Accepted 23 October 2008 Available online 13 November 2008 Keywords: Cardiac tissue in vivo and ex vivo Magnetic resonance spectroscopy Creatine Phosphocreatine abstract Ó 2008 Elsevier B.V. All rights reserved. Contents 1. Introduction ......................................................................................................... 256 2. Basic principles and methodology........................................................................................ 256 2.1. Data acquisition................................................................................................. 256 2.2. Data analysis ................................................................................................... 256 3. 31 P spectroscopy: cardiac high-energy phosphate metabolism................................................................. 256 3.1. Healthy heart ................................................................................................... 257 3.2. Ischemic heart disease ........................................................................................... 258 3.2.1. Myocardial infarction ..................................................................................... 258 3.2.2. Persistent wall motion abnormalities ........................................................................ 258 3.2.3. Magnetic resonance (MR) stress test ......................................................................... 259 3.3. Valvular heart disease ............................................................................................ 260 3.3.1. Aortic valvular diseases ................................................................................... 260 3.3.2. Mitral valvular diseases ................................................................................... 261 3.4. Hypertensive heart disease ........................................................................................ 261 3.5. Cardiomyopathy and failing heart .................................................................................. 261 3.6. Cardiac transplantation ........................................................................................... 262 3.7. Stem cell transplantation ......................................................................................... 263 3.8. 31 P MRS: a clinical tool? .......................................................................................... 263 4. 1 H MR spectroscopy ................................................................................................... 264 4.1. 1 H MRS in the assessment of myocardial creatine ..................................................................... 264 4.2. Importance of myocardial lipids.................................................................................... 267 4.3. 1 H MRS in the assessment of myocardial triglycerides .................................................................. 268 4.4. Other proton MR visible cardiac metabolites: high resolution magic angle spinning (MAS) NMR spectroscopy .................... 270 5. Other nuclei ......................................................................................................... 271 5.1. 23 Na MR spectroscopy ............................................................................................ 271 5.2. 13 C MR spectroscopy ............................................................................................. 271 5.3. 87 Rb MR spectroscopy ............................................................................................ 272 5.4. 19 F MR spectroscopy ............................................................................................. 273 0079-6565/$ - see front matter Ó 2008 Elsevier B.V. All rights reserved. doi:10.1016/j.pnmrs.2008.10.004 * Corresponding author. Tel.: +1 310 206 4191; fax: +1 310 825 5837. E-mail address: athomas@mednet.ucla.edu (M.A. Thomas). Progress in Nuclear Magnetic Resonance Spectroscopy 54 (2009) 255–277 Contents lists available at ScienceDirect Progress in Nuclear Magnetic Resonance Spectroscopy journal homepage: www.elsevier.com/locate/pnmrs