Lack of association between serum syndecan-4, myocardial fibrosis and ventricular dysfunction in subjects with chronic Chagas disease

<div><p>Background</p><p>Syndecan-4 is a transmembrane glycoprotein associated with inflammation and fibrosis. Increased syndecan-4 levels were previously detected after acute myocardial infarction and in subjects with heart failure. However, the levels of syndecan-4 in subjects with Chagas disease have not so far been investigated. The aim of this study was to investigate the potential role of serum sydencan-4 as a novel biomarker for myocardial fibrosis and cardiac dysfunction in subjects with Chagas disease.</p><p>Methods</p><p>This study comprised subjects with Chagas disease (n = 56), being 14 (25%) with the indeterminate form, 16 (29%) with the cardiac form without ventricular dysfunction, and 26 (46%) with the cardiac form with ventricular dysfunction.</p><p>Results</p><p>Syndecan-4 serum concentrations did not correlate with presence or absence of myocardial fibrosis (P = 0.386) nor disease severity in subjects with Chagas disease (P = 0.918). Additionally, no correlation was found either between the degree of myocardial fibrosis and serum syndecan-4 [r = 0.08; P = 0.567] or between left ventricular ejection fraction and syndecan-4 [r = 0.02; P = 0.864]. In contrast, NT-proBNP levels correlated with ejection fraction and myocardial fibrosis.</p><p>Conclusions</p><p>Our results demonstrate the lack of correlations between serum syndecan-4, myocardial fibrosis and cardiac dysfunction in subjects with Chagas disease. Further studies are required to show if syndecan-4 concentrations can be marker for prognosis assessment or disease progression.</p></div

Correlation between percentage of myocardial fibrosis assessed by cardiovascular MRI and concentration of syndecan-4 and NT-ProBNP.

<p>A: Pearson’s correlation, r = 0.08, P = 0.567. B: Pearson’s correlation, r = 0.469, P<0.001.</p

Echocardiographic and CMR findings in subjects with Chagas disease.

<p>Echocardiographic and CMR findings in subjects with Chagas disease.</p

Clinical and demographic characteristics of subjects with Chagas disease.

<p>Clinical and demographic characteristics of subjects with Chagas disease.</p

Correlation between LVEF and serum concentration of syndecan-4 and NT-ProBNP.

<p>A: Pearson’s correlation, LVEF assessed by Simpson’s method, r = 0.02, P = 0.864. B = Pearson’s correlation, LVEF assessed by Simpson’s method, r = 0.687, P<0.001.</p

Serum concentration of syndecan-4 assessed by ELISA in subjects with different forms of Chagas disease.

<p>ANOVA, P = 0.918. Circle = outlier, * = extreme outlier, P = 0.395.</p

Serum concentration of syndecan-4 assessed by ELISA in subjects with and without delayed enhancement detected by magnetic resonance imaging.

<p>Circle = outlier, * = extreme outlier, <i>t</i> test, P = 0.386.</p

Echocardiographic data in subjects with heart failure.

<p>Echocardiographic data in subjects with heart failure.</p