Abstract
BACKGROUND: Sepsis-induced cardiomyopathy (SIC), a major complication of sepsis characterized by myocardial injury and cardiac dysfunction, significantly increases mortality. Inflammation plays a central role in SIC, yet specific biomarkers for early diagnosis remain limited. This study aimed to identify inflammatory cytokines associated with SIC and evaluate their diagnostic potential. METHODS: Serum levels of 40 immune-related cytokines were measured in 25 SIC patients, 25 sepsis patients, and 10 healthy controls using antibody microarrays. Correlation analysis examined associations between cytokines and clinical parameters, while Receiver operating characteristic (ROC) curves and logistic regression assessed their predictive accuracy for myocardial dysfunction. RESULTS: Urokinase-type plasminogen activator receptor (uPAR) was found to be significantly elevated in SIC patients compared to sepsis patients and healthy controls. Furthermore, uPAR levels were found to significantly and positively correlated with Acute Physiology and Chronic Health Evaluation II (APACHE II) score, sequential organ failure assessment score (SOFA), B-type natriuretic peptide (BNP), as well as the use and duration of vasopressor therapy, and negatively correlated with fraction of shortening (FS). ROC curve analysis showed that the predictive value of uPAR was inferior to that of BNP, cardiac troponin I (cTnI), and FS; while superior to that of left ventricular end-diastolic dimension (LVEDD). Logistic regression analysis showed that uPAR significantly affected the occurrence of myocardial dysfunction. CONCLUSION: Our study suggests that uPAR may serve as a candidate biomarker associated with SIC. Combining uPAR with other markers could enhance diagnostic accuracy. Additionally, uPAR levels may be associated with vasopressor use in SIC patients.