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Severe sepsis and septic shock are among the leading causes of admission to intensive care units (ICUs), with high mortality rates. Myocardial depression is a well-recognized manifestation of organ dysfunction in sepsis. CST has been recently identified as a mediator of various beneficial effects in animal models of sepsis. At present, no data are available concerning the levels of CST in sepsis patients. In sepsis the plasma amino acid pattern is characterized by decreased branced chain amino acids (BCAAs). We investigated the levels of plasma CST, branched-chain α-ketoacid dehydrogenase kinase (BCKDK), cardiac function and their relationships to component traits in patients with sepsis.
Data were collected during a 9-month period between Jan and September, 2016, department of Emergency at The Affiliated Hospital of Harbin Medical University. We included patients in the study and divided them into two groups based on the severity of infection. CST and BCKDK levels were measured by ELISA kits. The levels of PCT, lactic acid, platelet and serum creatinine were assessed by routine biochemical analysis.
CST and BCKDK levels were significantly higher in patients with sepsis than in controls: the median plasma CST concentration was 103.1 ng/ml (range, < 83.13-189.7 ng/ml) in patients with sepsis and 49.69 ng/ml (range, < 19.38-100.8 ng/ml) in controls (p=0.0022); the median plasma BCKDK concentration was 745 ng/ml in sepsis group and 801.7 ng/ml in controls (p=0.0292). Additionally, there was correlation between the plasma concentrations of CST and BCKDK in sepsis patients (r2=0.6357, p < 0.01).
We conclude that the plasma levels of CST in sepsis patients were higher than in controls, and there is a relationship between CST and BCKDK in sepsis patients. Also, there is a relationship between CST and cardiac function in sepsis patients. Future experimental and clinical studies are needed to evaluate CST as a novel prognostic tool in sepsis patients with heart injury and its potential therapeutic use in sepsis.