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Oxylipins are lipid signaling molecules linked to adverse HFpEF outcomes, but their relationship with obesity remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate association between obesity and arterialized and venous oxylipins in HFpEF patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this prospective single-center cohort study, 90 patients with HFpEF underwent transthoracic echocardiography and right heart catheterization with arterialized pulmonary capillary and venous blood sampling. Serum oxylipins were quantified via liquid chromatography-mass spectrometry. Oxylipin levels were log-transformed and standardized. Oxylipin associations with obesity (BMI\u2009\u2265\u200930\u00a0kg\/m\u00b2) were evaluated using logistic regression, and pulmonary hypertension (PH) subgroup analyses using a one-sample proportion test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 90 patients, 61 (67.8%) were obese. Obese patients were younger, more frequently female and African American, had higher prevalence of diabetes (54.1% vs. 17.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and exhibited greater interventricular septal and posterior wall thickness. Multivariable and volcano plot analyses demonstrated inverse associations between obesity and several arterialized oxylipins, including 12,13-DiHOME (OR:0.48;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), 19,20-DiHDoPE (OR:0.53;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03), 11,12-DiHETrE (OR:0.31,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.04), 9,10-DiHOME (OR;0.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02), and 5(S),6(S)-DiHETE (OR:0.51;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02). In contrast, arterialized 19R-hydroxy-prostaglandin E1 was positively associated with obesity (OR:1.91,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.03). Among venous oxylipins, 15(R)-PGE1 (OR:2.23;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) and 19R-hydroxy-prostaglandin E1 (OR:1.91;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.02) showed positive associations with obesity. Obese patients constituted a higher proportion of combined pre- and post-capillary PH subgroup (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Obesity in HFpEF is associated with reduced oxylipin diol levels, higher levels of prostaglandin E1 metabolites, and higher burden of pulmonary hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11306-026-02449-x","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:06:26Z","timestamp":1778511986000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obesity is associated with distinct oxylipins in heart failure with preserved ejection fraction"],"prefix":"10.1007","volume":"22","author":[{"given":"Ashish","family":"Yadav","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sareeta","family":"Manandhar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alex","family":"Kloster","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vaishnavi","family":"Aradhyula","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krishna Rao","family":"Maddipati","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George V.","family":"Moukarbel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Kennedy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samer J.","family":"Khouri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajesh","family":"Gupta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,11]]},"reference":[{"issue":"6","key":"2449_CR1","doi-asserted-by":"publisher","first-page":"4255","DOI":"10.1002\/ehf2.15425","volume":"12","author":"V Aradhyula","year":"2025","unstructured":"Aradhyula, V., Manandhar, S., Sherafati, A., et al. 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This relationship is unrelated to the current study and did not influence its design, execution, analysis, interpretation of data, writing of the manuscript, or the decision to submit for publication. Samer J. Khouri: Dr. Khouri discloses funding from Gilead Sciences for the original cohort study. This funding is unrelated to the current sub-analysis and did not influence its design, execution, analysis, interpretation of data, writing of the manuscript, or the decision to submit for publication. David J Kennedy: Dr. Kennedy discloses funding from EMD Millipore (related to US Patent US8524507B2) and Abbott, Inc. These relationships are unrelated to the current study and did not influence its design, execution, analysis, interpretation of data, writing of the manuscript, or the decision to submit for publication.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}},{"value":"The Institutional Review Board of University of Toledo approved both the study methods and research protocol. Each patient provided written informed consent before enrolling. All procedures adhered strictly to ethical and institutional guidelines.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"During preparation of this work, the authors used Grammarly to improve the language and grammar of the text. After using this tool\/service, the authors reviewed and edited the content as needed and take full responsibility for the content of the published article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declaration of generative AI and AI-assisted technologies in the manuscript preparation process"}}],"article-number":"69"}}