Abstract:

Objective To examine the correlation between ferroptosis-related gene expression levels and myocardial dysfunction as well as prognosis in sepsis patients. Methods Eighty-five sepsis patients admitted to our hospital from May 2023 to August 2024 were categorized into two groups based on the presence of myocardial dysfunction： the impaired group （n = 39） and the non-impaired group （n = 46）. The mRNA expression levels of cytochrome P450 oxidoreductase （POR）， solute carrier family 7 member 5 （SLC7A5）， and signal transducer and activator of transcription 3 （STAT3） were measured. Multivariate logistic regression analysis was conducted to examine the correlation between the expression levels of iron death-related genes and sepsis-induced myocardial dysfunction （SIMD）. Kaplan-Meier survival curves were plotted to evaluate the relationship between the expression levels of iron death-related genes and the prognosis of sepsis patients. Results In patients with sepsis， the disorder group exhibited higher male proportions， age， and expression levels of POR， SLC7A5， and STAT3 compared to the non-disorder group （P < 0.05）. After adjusting for potential confounders such as gender and age， the expression levels of POR， SLC7A5， and STAT3 remained independent predictors of SIMD （P < 0.05）. The ROC curve analysis revealed that the AUC for POR expression in predicting SIMD was 0.677 （95%CI： 0.561 ~ 0.792）， with a sensitivity of 87.20% and specificity of 54.30%. For SLC7A5， the AUC was 0.844 （95%CI： 0.749 ~ 0.939）， with a sensitivity of 74.40% and specificity of 93.50%. STAT3 had an AUC of 0.690 （95%CI： 0.570 ~ 0.809）， with a sensitivity of 69.20% and specificity of 71.70%. During the follow-up period， 69 patients （81.18%） survived， while 16 （18.82%） did not. Kaplan-Meier survival analysis indicated that POR and SLC7A5 expression levels were significantly associated with the 28-day survival rate of septic patients （χ2 = 6.048/10.143， P < 0.05）， whereas STAT3 expression showed no significant correlation （χ2 = 2.149， P > 0.05）. Conclusion The expression levels of POR， SLC7A5 and STAT3 are closely related to SIMD， and the expression levels of POR and SLC7A5 are significantly related to the prognosis of sepsis patients.

Key words: iron death, sepsis, myocardial dysfunction, prognosis, correlation