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Cardiac 31P MR spectroscopy: development of the past five decades and future vision—will it be of diagnostic use in clinics?

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Abstract

In the past five decades, the use of the magnetic resonance (MR) technique for cardiovascular diseases has engendered much attention and raised the opportunity that the technique could be useful for clinical applications. MR has two arrows in its quiver: One is magnetic resonance imaging (MRI), and the other is magnetic resonance spectroscopy (MRS). Non-invasively, highly advanced MRI provides unique and profound information about the anatomical changes of the heart. Excellently developed MRS provides irreplaceable and insightful evidence of the real-time biochemistry of cardiac metabolism of underpinning diseases. Compared to MRI, which has already been successfully applied in routine clinical practice, MRS still has a long way to travel to be incorporated into routine diagnostics. Considering the exceptional potential of 31P MRS to measure the real-time metabolic changes of energetic molecules qualitatively and quantitatively, how far its powerful technique should be waited before a successful transition from “bench-to-bedside” is enticing. The present review highlights the seminal studies on the chronological development of cardiac 31P MRS in the past five decades and the future vision and challenges to incorporating it for routine diagnostics of cardiovascular disease.

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Availability of data and materials

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

Abbreviations

[ADP]:

Adenosine diphosphate concentration

[AMP]:

Adenosine monophosphate concentration

[ATP]:

Adenosine triphosphate concentration

[PCr]:

Phosphocreatine concentration

2-DG:

2-Deoxyglucose

5′-NT:

5′-Nucleotidase

A3AR:

A3 adenosine receptor

AdR:

Adenosine receptors

ADR:

Adriamycin

AF:

Atrial fibrillation

AGAT:

Arginine:glycine amidinotransferase

AK:

Adenylate kinase

AoB:

Aortic banding

AS:

Aortic stenosis

AS:

Aortic stenosis

ATPase:

ATP synthase

BCAA:

Branched chain amino acid

BCW:

Normal cardiac work-states

BOAST:

Bloch-Siegert four angle saturation transfer

BP:

Blood pressure

CD:

Chagas’ disease

CF:

Coronary perfusion flow

CH:

Cardiac hypertrophy

CHF:

Chronic heart failure

CK:

Creatine kinase

CLN:

Calcineurin

CMRS:

Cardiac MRS

CN:

Sodium cyanide

CP:

Chuvash polycythemia

Cr:

Creatine

CrT-OE:

Creatine transporter overexpress

CSI:

Chemical shift imaging

dATP:

2-Deoxy-ATP

DCD:

Diastolic chamber distensibility

DCM:

Dilated cardiomyopathy

DGP:

2-Deoxyglucose-6-phosphate

DKO:

Double knockout

DOX:

Doxorubicin

DpDb:

Dopamine and dobutamine

DRESS:

Depth-resolved surface coil spectroscopy

EDP:

End diastolic pressure

EDV:

End diastolic volume

EF:

Ejection fraction

EMPA:

Empagliflozin

eNO:

Endogenous nitric oxide

ERT:

Enzyme replacement therapy

ESV:

End systolic volume

ET:

Exercise training

EUT:

Euthyroid

F-2,6-P2:

Fructose-2,6-bisphosphate

FAST:

Four-angle saturation transfer

FD:

Fabry disease

FHC:

Familial hypertrophic cardiomyopathy

FID:

Free induction decay

GA:

Guanidinoacetate

GAMT:

Guanidinoacetate N-methyltransferase

GH:

Growth hormone

GLB:

Glibenclamide

GLUT1:

Glucose transporter protein 1

GLUT4 (G4N):

Glucose transport protein 4

HA:

Homoarginine

HB:

Hibernating myocardium

HC:

Healthy control

HCM:

Hypertrophic cardiomyopathy

HCW:

Very high cardiac work-states

HEP:

High-energy phosphate

hESC-VCs:

Human nascent stem cell–based vascular cells

HFHS:

High-fat-high-sucrose

HHD:

Hypertensive heart disease

HIF:

Hypoxia inducible factor

HL:

Halothane

HR:

Heart rate

HT:

Heart transplants

I/R:

Ischemia/reperfusion

IA:

Iodoacetamide

IDC:

Idiopathic dilated cardiomyopathy

IGF-1:

Insulin-like growth factor-1

IPC:

Ischemic pre-conditioning

IRS:

Insulin-receptor-substrate

ISIS:

Surface coil image–based in vivo spectroscopy

ISO:

1,5-Dihydroxyisoquinoline

KCl:

Potassium chloride

kfor :

Pseudo-first-order rate constant

KO:

Knockout

LGE:

Late gadolinium enhancement

LV:

Left ventricle

LVDP:

Left ventricular developed pressure

LVEDP:

Left ventricle end diastolic pressure

LVEF:

Left ventricle ejection fraction

LVH:

Left ventricular hypertrophy

LVmass:

Left ventricle mass

LVP:

LV pressure

LVSP:

Left ventricular systolic pressure

MBF:

Myocardial blood flow

MCK:

Myofibrillar isoform of CK

MHD:

Metabolic heart disease

MI:

Myocardial infarction

MPC:

Multi-potent progenitor cells

MR:

Magnetic resonance

MRI:

Magnetic resonance imaging

MRS:

Magnetic resonance spectroscopy,

MST:

Magnetization saturation transfer

mtCaMKII:

Mitochondrial calmodulin kinase II

MtCK:

Mitochondrial isoforms of CK

MVO2 :

Oxygen consumption

NHE:

Na+/H+ exchange

NMR:

Nuclear magnetic resonance

NNA:

Neural network analysis

NO:

Nitric oxide

NTP:

Nucleoside triphosphate

NYHA:

New York Heart Association

OP:

Oxidative phosphorylation

PARS:

Poly(ADP-ribose) synthetase

PBS:

Phosphate-buffered saline

PCr/ATP ratio:

Phosphocreatine/adenosine triphosphate ratio

PD:

Phospholamban-deficient

PDH:

Pyruvate dehydrogenease

PF:

Preserved ventricular function

PFK:

Phosphofructokinase

PFR:

Peak filling rate

PGAA:

Guanidinoacetate phosphate

PI3-k:

Phosphatidylinositol-3-kinase

PKC:

Protein kinase C

PP:

Phenylphosphonate

PPARα:

Peroxisome proliferator-activated receptor α

RF:

Radiofrequency

ROS:

Reactive oxygen species

RPP:

Rate-pressure product

RSV:

Resveratrol

RV:

Right ventricle hypertrophy

RV:

Right ventricle

SAR:

Specific absorption rate

SERCA:

Sarco-endoplasmic reticulum Ca2+-ATPase

SGLT2:

Sodium-glucose co-transporter 2

SHR:

Spontaneously hypertensive rat

SLIF:

Scattered light intensity fluctuations

SLOOP:

Spatial localized with optimum point-spread

SNAC:

S-nitrosoacetylcysteine

SNR:

Signal-to-noise ratio

SOD:

Superoxide dismutase

ssTnI:

Slow skeletal muscle troponin I

STEAM:

Stimulated echo acquisition mode

STF:

Systolic thickening fraction

StreST:

Stressed saturation transfer

STZ:

Streptozotocin

SV:

Stroke volume

T2D:

Type 2 diabetes

T3:

Hyperthyroid

TAC:

Transverse aorta constriction

TAN:

Adenine nucleotide pool

TCA:

Tricarboxylic acid

TG:

Transgenic

TgRR:

Ribonucleotide reductase

TnI:

Troponin I

TRiST:

Triple repetition time saturation transfer

TwiST:

Two-repetition time saturation transfer

VB:

Ventricular fibrillation

VD:

Ventricular dysfunction

WT:

Wild type

XOI:

Xanthine oxidase inhibition

ZDF:

Zucker diabetic fatty

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    Ashish Gupta

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Gupta, A. Cardiac 31P MR spectroscopy: development of the past five decades and future vision—will it be of diagnostic use in clinics?. Heart Fail Rev 28, 485–532 (2023). https://doi.org/10.1007/s10741-022-10287-x

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