Metabolite levels in SSc-no PH vs SSc-PAH. Violin plots of nervonic acid, lignoceric acid, FHAFA, 17β estradiol, novel eicosanoid, PGF2α, and LTB4 levels in SSc-no PH vs SSc-PAH. All displayed metabolites had a P value < .05. FAHFA = fatty acyl esters of hydroxy fatty acid; LTB4 = leukotriene B4; PGF2α = prostaglandin F2α; SSc-PAH = systemic sclerosis-associated pulmonary arterial hypertension; SSc-no PH = systemic sclerosis without associated pulmonary arterial hypertension.