Circulating oxylipins predict mortality in heart failure with preserved ejection fraction

Area of Science:

• Cardiovascular Medicine
• Biomarker Discovery
• Oxylipins and Inflammation

Background:

• Heart failure with preserved ejection fraction (HFpEF) presents significant challenges in diagnosis, prognosis, and treatment.
• Limited predictors of outcomes exist for HFpEF patients, highlighting a critical unmet need.
• Oxylipins, circulating lipids involved in inflammation, have potential but unproven prognostic value in HFpEF.

Purpose of the Study:

• To investigate the potential of oxylipins as predictors of mortality in HFpEF.
• To hypothesize that a panel of oxylipins can stratify mortality risk in HFpEF patients.

Main Methods:

• Collected arterial and venous blood samples from 90 HFpEF patients during right heart catheterization.
• Measured 143 arterial and 143 venous oxylipins using liquid chromatography-mass spectrometry.
• Analyzed 5-year mortality using volcano plots, ROC curves, and Kaplan-Meier analysis.

Main Results:

• Arterial 15-keto prostaglandin F2a (PGF2a) was significantly associated with 5-year mortality in HFpEF patients.
• Elevated arterial 15-keto PGF2a levels predicted increased 5-year mortality.
• Multivariable analysis confirmed 15-keto PGF2a as a significant predictor (OR 1.82).

Conclusions:

• Arterial 15-keto PGF2a is a significant predictor of 5-year mortality in HFpEF.
• This stable metabolite of PGF2a offers a promising biomarker for risk stratification in HFpEF.