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

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.