Nuclear magnetic resonance spectroscopic investigations of the human myocardium.
Magnetic resonance spectroscopy is a noninvasive technique for measuring the concentration of metabolites both in vivo and in solutions. The technique exploits the nuclear spin of certain isotopes, and measurements of signals from the nuclei of phosphorus atoms ((31)P) have provided much new information about high-energy phosphates and reaction fluxes in energy provision and utilization. The method has been systematically applied in the isolated heart preparation and the surgically exposed heart, and the effects of ischemia and other interventions have been documented. In humans, the ratio of phosphocreatine to adenosine triphosphate in the heart that has been determined both at rest and during exercise has been shown to be a sensitive index for impairment in cardiac metabolism in patients with myocardial hypertrophy due to aortic valve disease and during hand-grip exercise in patients with ischemia. It is now practical to use (31)P magnetic resonance spectroscopy to extend our understanding of myocardial metabolism in health and disease and to assess the response to therapy and the rejection of the transplanted heart.
MRC Biochemical and Clinical Magnetic Resonance Unit, Department of Biochemistry, Oxford University, Oxford OX1 3QU, England.
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