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To induce changes in myocardial metabolism monitored by 31P MRS in patients with symptoms of coronary artery disease, handgrip stress test is frequently used. At a level of stress of 30% maximum voluntary contraction, it is critical to maintain a continuous stress level. Otherwise, the phosphate metabolic alterations tend to recover quickly, and any changes would disappear with involuntary loss of the stress. In practice, it is very difficult for patients to maintain a constant pressure level and involuntary adaptation of the patient would interfere with the measurement of such changes.

Development of control system for optimal stress during cardiac MR spectroscopy