Spinning to a Different Beat: Non-Proton Cardiac NMR and MRI

Non-proton spectroscopy is a powerful tool that allows the assessment of specific and significant metabolites in cardiac tissue, such as key intermediates in energy metabolism. The technique uses spectroscopy, or less often imaging, of nuclei such as ³¹P, ¹⁹F and ²³Na. Due to the non-invasive nature of MRS, the technique is also applicable in the clinic, where it is used to assess changes in cardiac metabolism, such as due to a heart infarct. This chapter reviews the main developments in non-proton cardiac MRS and MRI, both clinical and preclinical. Major issues and challenges are also summarized. Finally, the promise of exciting new developments, particularly hyper-polarization, is discussed.

Keywords: 19F, 23Na, 31P, ATP, chemical shift, clinical, energy metabolism, hyperpolarization, lanthanide, metabolism, MRS, spectroscopy, multimodal, NMR, noninvasive, non-proton, preclinical, quantification, sensitivity, spectrum.