Pulmonary vascular disease & thromboembolismCross-sectional study

Fatty Acid and Oxylipin Metabolism Differentiate Isolated Postcapillary From Combined Pre- and Postcapillary Pulmonary Hypertension

Circ Heart FailPublished

  • cross-sectional study

Authors' conclusion

Cpc-PH exhibits a distinct, PAH-like metabolomic signature characterized by higher polyunsaturated fatty acids and fatty acyl esters of hydroxy fatty acids and lower pro-resolvin/vasodilatory oxylipins compared with isolated postcapillary PH. These findings have implications for PH classification, may inform diagnostic strategies, and nominate lipid pathways for therapeutic targeting.

Study context

Population
Patients with isolated postcapillary pulmonary hypertension (PH), Cpc-PH, or pulmonary arterial hypertension (PAH), as well as plasma samples from animal models of severe PHisolated postcapillary PH 21 · Cpc-PH 69 · PAH 38
Participants
128 patients
Exposure
Cpc-PH vs isolated postcapillary PH, and Cpc-PH vs PAH
  • isolated postcapillary PHn = 21
  • Cpc-PHn = 69
  • PAHn = 38

Main finding

As reported in the abstract

Metabolites differing between Cpc-PH and isolated postcapillary PH

Profiled metabolites

844

Differed between Cpc-PH and isolated postcapillary PH

158

Of those, higher in Cpc-PH, particularly polyunsaturated fatty acid and fatty acyl esters of hydroxy fatty acid pathways

28

Of these 28, did not differ from PAH (PAH-like bioactive lipid signature)

24

Observational data: associations, not effects.

Further findings

Mortality

Adrenic acid, linoleic acid, docosatrienoic acid, palmitoleic acid, and fatty acyl esters of hydroxy fatty acids associated with increased mortality

Su/Hx rat model of PAH

A subset of Cpc-PH-elevated metabolites was similarly increased

Original publication

Fatty Acid and Oxylipin Metabolism Differentiate Isolated Postcapillary From Combined Pre- and Postcapillary Pulmonary Hypertension. Circ Heart Fail. Published 10 September 2026. doi:10.1161/circheartfailure.125.014073

Summarised from the published abstract; every number is checked against it