Evaluation of Cardiac Metabolism by Magnetic Resonance Spectroscopy in Heart Failure.

Alterations in myocardial energy metabolism as demonstrated by magnetic resonance spectroscopy (MRS) are critically involved in heart failure development. H-MRS allows investigation of the role of myocardial lipid accumulation in the pathophysiology of heart failure. With P-MRS, the most useful parameter is the cardiac adenosine triphosphate to phosphocreatine ratio, which is typically reduced in the failing heart and correlates with cardiac functional status. Currently, MRS is mostly limited to the research setting, but recent technical and methodological developments might substantially improve its clinical applicability for initial characterization and successive monitoring of patients with heart failure.