Ischaemia-reperfusion injury is a key pathophysiological process driving cardiac injury in myocardial infarction, heart surgery and transplants. Succinate accumulation is a specific marker of ischaemic injury, and a potential therapeutic target to reduce reperfusion injury.Single-voxel proton spectra were acquired during normal perfusion and during ischaemia in three machine-perfused porcine hearts. During ischaemia, a peak was evident in the expected region of succinate, which was absent during normal perfusion. This was further examined in a phantom model which confirmed the peak location with concentration-signal correlation of R>0.999. MRS detection of succinate holds potential for the detection of ischaemia.
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