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Updated: Jul 25, 2025

Oxygenation-sensitive Cardiac MRI with Vasoactive Breathing Maneuvers for the Non-invasive Assessment of Coronary Microvascular Dysfunction
Published on: August 17, 2022
Trans-myocardial omega-3 fatty acid gradient in coronary microvascular dysfunction
Ellen C Keeley1, Eileen M Handberg1, C Noel Bairey Merz2
1Department of Medicine, Division of Cardiovascular Medicine, University of Florida, Gainesville, FL, United States of America.
Background:
Cardiac remodeling is a process mediated, in part, by 18-hydroxyeicosapentaenoic acid (HEPE), a metabolite of the omega-3 polyunsaturated fatty acid, eicosapentaenoic acid (EPA). We hypothesized that trans-myocardial levels of 18-HEPE could inform the pathophysiologic processes involved in heart failure with preserved ejection fraction (HFpEF).
Methods:
We measured the concentration of 18-HEPE and EPA in trans-myocardial plasma samples from 10 subjects enrolled in The Women's Ischemia Syndrome Evaluation [WISE] Mechanisms of Coronary Microvascular Dysfunction Leading to Pre-HFpEF project.
Results:
Concentrations of 18-HEPE were significantly lower in coronary venous compared to the aortic plasma (270.5 pg/mL [212.8-480.8] vs. 430.5 pg/mL [299.5-655.8], p = 0.0039). There was a significant correlation between the concentrations of coronary venous EPA and aortic 18-HEPE (r = 0.94, p = 0.0002), and aortic EPA and aortic 18-HEPE (r = 0.82, p = 0.0058).
Conclusions:
Results of this small pilot study support the suggestion that 18-HEPE is synthesized outside the heart and utilized within the myocardial bed.
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