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Studies typically report the phosphocreatine (PCr) to adenosine triphosphate (ATP) ratio. We focus on another <jats:sup>31<\/jats:sup>P signal: inorganic phosphate (Pi), whose chemical shift allows computation of myocardial pH, with Pi\/PCr providing additional insight into cardiac energetics. Pi is often obscured by signals from blood 2,3\u2010diphosphoglycerate (2,3\u2010DPG). We introduce a method to quantify Pi in 14\u00a0min without hindrance from 2,3\u2010DPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a <jats:sup>31<\/jats:sup>P stimulated echo acquisition mode (STEAM) sequence at 7 Tesla that inherently suppresses signal from 2,3\u2010DPG, the Pi peak was cleanly resolved. Resting state UTE\u2010chemical shift imaging (PCr\/ATP) and STEAM <jats:sup>31<\/jats:sup>P\u2010MRS (Pi\/PCr, pH) were undertaken in 23 healthy controls; pH and Pi\/PCr were subsequently recorded during dobutamine infusion.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We achieved a clean Pi signal both at rest and stress with good 2,3\u2010DPG suppression. Repeatability coefficient (8 subjects) for Pi\/PCr was 0.036 and 0.12 for pH. We report myocardial Pi\/PCr and pH at rest and during catecholamine stress in healthy controls. Pi\/PCr was maintained during stress (0.098 \u00b1 0.031 [rest] vs. 0.098 \u00b1 0.031 [stress] <jats:italic>P<\/jats:italic> = .95); similarly, pH did not change (7.09 \u00b1 0.07 [rest] vs. 7.08 \u00b1 0.11 [stress] <jats:italic>P<\/jats:italic> = .81). Feasibility for patient studies was subsequently successfully demonstrated in a patient with cardiomyopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We introduced a method that can resolve Pi using 7 Tesla STEAM <jats:sup>31<\/jats:sup>P\u2010MRS. We demonstrate the stability of Pi\/PCr and myocardial pH in volunteers at rest and during catecholamine stress. This protocol is feasible in patients and potentially of use for studying pathological myocardial energetics.<\/jats:p><\/jats:sec>","DOI":"10.1002\/mrm.28494","type":"journal-article","created":{"date-parts":[[2020,9,24]],"date-time":"2020-09-24T07:02:29Z","timestamp":1600930949000},"page":"1147-1159","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Quantifying the effect of dobutamine stress on myocardial Pi and pH in healthy volunteers: A <sup>31<\/sup>P MRS study at 7T"],"prefix":"10.1002","volume":"85","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0478-8918","authenticated-orcid":false,"given":"Andrew","family":"Apps","sequence":"first","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research (OCMR) Division of Cardiovascular Medicine, Radcliffe Department of Medicine University of Oxford Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2567-3642","authenticated-orcid":false,"given":"Ladislav","family":"Valkovi\u010d","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research (OCMR) Division of Cardiovascular Medicine, Radcliffe Department of Medicine University of Oxford Oxford United Kingdom"},{"name":"Department of Imaging Methods Institute of Measurement Science Slovak Academy of Sciences Bratislava Slovakia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Peterzan","sequence":"additional","affiliation":[{"name":"Oxford Centre for Clinical Magnetic Resonance Research (OCMR) Division of Cardiovascular Medicine, Radcliffe Department of Medicine University of Oxford Oxford United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7316-811X","authenticated-orcid":false,"given":"Justin Y. 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