Abstract 4139472: Increased Arachidonic Acid Eicosanoids in African Americans with Heart Failure with Preserved Ejection Fraction

Background: African Americans demonstrate increased prevalence, earlier onset, and worse prognosis of heart failure with preserved ejection fraction (HFpEF) compared to non-African Americans. Recent studies have implicated circulating, bioactive lipids such as eicosanoids in mediating systemic inflammation. Eicosanoids may play a role in HFpEF pathogenesis. In addition, prior studies have identified arachidonic acid (AA) gene variants in African Americans that predispose to elevated circulating AA eicosanoid levels. Objective: We sought to analyze the differences in eicosanoid levels between African American and non-African American patients with HFpEF. Methods: Venous and arterial blood samples were collected during right heart catheterization from 22 African American and 68 non-African American patients with HFpEF. AA lipids were analyzed using liquid chromatography-mass spectrometry. Statistical analysis was performed using Student’s unpaired T-test and Chi-squared analysis. Results: African American patients demonstrated higher venous anti-inflammatory prostaglandin E1 (PGE1) (p<0.0001), prostaglandin E2 (PGE2) (p=0.0002), pro-inflammatory thromboxane B3 (TXB3) (p=0.0152), pro-inflammatory 20-hydroxyeicosatetraenoic acid (20-HETE) (p<0.0001), anti-inflammatory 14,15-epoxyeicosatrienoic acid (14,15-DiHETrE) (p=0.0005), and pro-resolutory lipoxin A4 (LXA4) (p<0.0001). Similarly, African American patients had elevated arterial 20-HETE (p=0.0029) and LXA4 (p=0.0421). Conclusion: This study demonstrates significant differences in levels of venous and arterial eicosanoids between African Americans and non-African Americans with HFpEF.