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In addition to performing imaging scans, magnetic resonance imaging (MRI) scanners can monitor metabolism in the body using magnetic resonance spectroscopy (MRS). This chapter is intended to introduce clinicians to the wealth of information that can be obtained by MRS methods. The chapter begins with a brief introduction to the essential theory of MRS. It then describes typical human cardiac protocols for MRS of hydrogen (1H-MRS), phosphorus (31P-MRS), carbon (13C-MRS), and for imaging of sodium (23Na-MRI). The bulk of the chapter is then devoted to summarizing the principal contributions of MRS studies to our understanding of cardiac metabolism in the normal and diseased heart. In particular, we describe the current understanding of cardiac high-energy phosphate metabolism in healthy hearts, in the athletic heart, in heart failure (including cardiomyopathies and specific genetic defects), valvular heart disease and ischemic heart disease. We conclude by briefly reviewing the latest technical developments in cardiac MRS: scanning at ultra-high field strength (7 T), using hyper-polarized 13C contrast agents, and assessing MRS results through an integrative modeling approach.

Original publication





Book title

Cardiovascular Magnetic Resonance: A Companion to Braunwald’s Heart Disease

Publication Date



97.e6 - 107.e6