Cardiac H MR spectroscopy: development of the past five decades and future perspectives.

Continued advances in laboratory medicine are required to realize the potential of individualized medicine to impact common cardiovascular diseases. Magnetic resonance imaging (MRI) and spectroscopy (MRS) techniques have advanced over recent years and offer unique, powerful insights into cardiac anatomic and metabolic changes, respectively, occurring in both nascent and advanced heart disease. Although numerous MRI-based in vivo diagnostics are already used in routine clinical practice and more are anticipated, MRS has been less incorporated into routine clinical practice. Given the ability of H MRS to identify and quantify specific molecules with high sensitivity and specificity, its potential utility should be successfully transition from "bench-to-bedside" is tantalizing. The present review will highlight the development of H MRS techniques for cardiac applications, observations in seminal studies with H MRS, and the prospects and challenges for widespread application in patients with cardiovascular disease.