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Abstract
The purpose of this review is to give a brief historical context and overview of cardiac substrate metabolism, including recent discoveries, and then delve into newer advances in positron emission tomography (PET) myocardial metabolic imaging. Some of the recent discoveries of cardiac metabolism involve the pleiotropic effects of metabolism of minor substrates, such as ketones and branch chain amino acids. Contemporary advancements in cardiac imaging include the following: novel radiotracers, new technologies, and evidence showing how patient-specific attributes, such as sex and age, affect myocardial metabolism. Myocardial metabolism is a dynamic field with several new advances. PET imaging has allowed us to better quantify and understand the complexities of the heart’s metabolism and the effects of different conditions and therapies on the heart, as well as detect potentially life-threatening infections in heart failure patients with left ventricular assist devices (LVADs).
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