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 24-48h 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.