Eicosanoids in Coronary Sinus Correlate with NT-proBNP in Heart Failure with Reduced Ejection Fraction Indicated to Resynchronization Therapy: Insights from Eicosanoids in Human Heart Failure Study

Abstract Introduction The diagnostic potential of eicosanoids, metabolites of arachidonic acid with cardio-renal activity, in chronic heart failure with reduced ejection fraction (HFrEF) remains unclear. The aim was to investigate levels of eicosanoids in different body compartments and their relation to natriuretic peptides. Material and methods Eleven HFrEF patients indicated to cardiac resynchronization therapy (CRT) were enrolled to measure 14,15-epoxyeicosatrienoic acid (14,15-EET), 14,15-dihydroxyicosatrienoic acid (14,15-DHET) and N-terminal pro B-type natriuretic peptide (NT-proBNP) levels from venous, arterial, and coronary sinus (CS) blood samples. Results In CS, NT-proBNP negatively correlated with plasmatic 14,15-EET (r = − 0.63, p = 0.03) and positively with the DHET/EET ratio (r = 0.73, p = 0.02). This correlation was not found in the other compartments. Plasmatic 14,15-EET nor 14,15-DHET levels in measured compartments did not differ statistically (p = 0.21, p = 0,64, respectively). In individual patients, the levels of both eicosanoids correlated across all compartments. Peripheral plasma 14,15-EET levels in controls were lower compared to HFrEF patients. Conclusions Peripheral venous eicosanoid (14,15-EET, 14,15-DHET) levels correlate and do not differ from arterial and CS levels in patients with HFrEF indicated to CRT. In CS, NT-proBNP negatively correlates with plasmatic 14,15-EET and positively with the DHET/EET ratio, an indirect measurement of soluble epoxide hydrolase (sEH) activity, suggesting an important role of eicosanoids and sEH in HFrEF pathophysiology. Graphical abstract