Fatty acid metabolites concentration in the early phase of myocardial infarction and its relation to left ventricular ejection fraction.

BACKGROUND

Acute inflammation after myocardial infarction (MI) is required for healing, but inadequate resolution may contribute to adverse remodeling and heart failure. Specialized pro-resolving mediators (SPMs) and eicosanoids derived from polyunsaturated fatty acids regulate the intensity and duration of inflammation.

OBJECTIVE

To assess whether circulating fatty acid metabolites measured early after MI are associated with post-infarction left ventricular ejection fraction (LVEF).

METHODS

This study included 164 patients with MI (STEMI and NSTEMI) treated with primary percutaneous coronary intervention (PCI). Blood samples were collected 24-48 h after PCI. Fatty acid metabolites were isolated by solid-phase extraction and quantified using HPLC with diode-array detection. Transthoracic echocardiography was performed before discharge; patients were categorized as low-EF (LVEF <40%, n = 31) or preserved-EF (LVEF ≥40%, n = 133). Group differences were tested using t-tests; Pearson correlations were calculated for selected metabolites.

RESULTS

Low-EF patients had higher hs-troponin and white blood cell count than preserved-EF patients (p = 0.035 and p = 0.040). Concentrations of leukotriene B4 and 12(S)-HETE were higher in the low-EF group (p = 0.040 and p = 0.020), whereas resolvin E1, maresin 1, and lipoxin A4 were lower (p = 0.0001, p = 0.040, and p = 0.010). No significant differences were observed for resolvin D1, thromboxane B2, or prostaglandin E2.

CONCLUSIONS

Early after MI, reduced LVEF is associated with higher pro-inflammatory lipid mediators and lower pro-resolving mediators, suggesting an imbalance between inflammatory activation and resolution in patients with early systolic dysfunction.