Synopsis

There are many molecular applications emerging in cardiac MR which give us useful research and clinical insights. 31-phosphorus magnetic resonance spectroscopy demonstrates relative amounts of ATP and Phosphocreatine, showing energy metabolism. Proton spectra can demonstrate cardiac lipid build up or total creatine levels. 31-carbon spectroscopy can be used with dynamic nuclear polarisation to demonstrate metabolism of carbon containing compounds, typically pyruvate in showing up glucose metabolism. 31P MRS has demonstrated to us PCr depletion in heart failure and on exercise in states where energy supply is limiting. 13C shows reduced glycolysis and may be useful in ischaemia imaging.