Division of Cardiology, Ospedale Accreditato Villa dei Fiori, Acerra, Naples, Italy; Zena and Michael A. Wiener Cardiovascular Institute/Marie-Josee and Henry R. Kravis Center for Cardiovascular Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA. Electronic address: [Email]
Alterations in myocardial energy metabolism as demonstrated by magnetic resonance spectroscopy (MRS) are critically involved in heart failure development. 1H-MRS allows investigation of the role of myocardial lipid accumulation in the pathophysiology of heart failure. With 31P-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.