Predicting Sepsis in Heart Failure Patients Supported by Left Ventricular Assist Devices: The Role of VE-Cadherin and ADAM10

TL;DR

This study shows that VE-Cadherin and ADAM10 levels in blood can help predict sepsis in heart failure patients using a left ventricular assist device.

Contribution

The study introduces VE-Cadherin and ADAM10 as potential biomarkers for predicting sepsis in LVAD patients.

Findings

Plasma VE-Cadherin and ADAM10 levels were significantly higher in patients who developed sepsis.

VE-Cadherin alone showed good predictive performance for sepsis with AUC values ranging from 0.69 to 0.81.

Combining VE-Cadherin with ADAM10 improved the predictive performance of sepsis prediction models.

Abstract

Vascular endothelial cadherin (VE-Cadherin) is a major endothelial adhesion molecule and can be cleaved explicitly by metalloproteinase domain-containing protein 10 (ADAM10). Vascular hyperpermeability may contribute to a greater susceptibility to sepsis in left ventricular assist device (LVAD) support patients. We aim to evaluate the efficacy of VE-Cadherin and ADAM10 for predicting sepsis in LVAD patients. We prospectively recruited 50 patients with advanced heart failure receiving LVAD therapy. Baseline and weekly postoperative blood samples (weeks 1–4) were collected, and plasma VE-cadherin and ADAM10 levels were measured. Sepsis occurred in 9 of 50 patients (18.0%). Across all sampling points, plasma VE-cadherin and ADAM10 levels were significantly higher in the sepsis group relative to the non-sepsis group. From pre-implantation to 1-week and 1-month post-operation, VE-Cadherin alone showed good performance for sepsis prediction, with areas under the receiver operating characteristic (AUC) of 0.75, 0.81, 0.69, 0.72, and 0.77, respectively. A significant positive correlation between VE-cadherin and ADAM10 was detected only among sepsis patients. Incorporating ADAM10 into the prediction models significantly enhances their predictive performance. Plasma VE-Cadherin levels can be a valuable biomarker for predicting sepsis in LVAD patients, with predictive performance further enhanced when combined with circulating ADAM10 levels.

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