Abstract: Cardiomyocytes use various substrates such as glucose, fatty acids, lactic acid, and ketone bodies to produce energy to maintain their normal systolic and diastolic function. Abnormal changes in cardiomyocytes' energy metabolism are associated with various heart diseases, such as myocardial ischemia and heart failure. As a non-invasive functional examination method, radionuclide imaging can be used to evaluate the metabolism status of cardiomyocytes. Radionuclide myocardial metabolism imaging agents are myocardial metabolism substrates. Their analogues are labeled with radionuclides, divided into oxygen metabolism imaging agents, glucose metabolism imaging agents, and fatty acid metabolism imaging agents. This paper reviews the research progress of positron radionuclide myocardial metabolism imaging agents in recent years.