The Variations And Significance Of Syndecan-4in Patients With Chronic Heart Failure

Objectives:This study aimed to observe the serum level variations of syndecan-4in the patients with chronic heart failure, find out the correlation among NT-proBNP, left ventricular ejection fraction(LVEF), left ventricular mass index (LVMI), and investigate the role of syndecan-4in evaluating the diagnosis and prognosis of chronic heart failure.Methods:One hundred and twenty four patients with chronic heart failure and35control subjects hospitalized in the Cardiology department of the Second Xiangya Hosptial, Central South University were enrolled in the study. The clinical and echocardiographic parameters were recorded. Concentration of serum syndecan-4and NT-proBNP were measured. All measure value was analyzed by using the19.0SPSS software.Results:1. The levels of lnSDC4(1.47±0.2vs1.73±0.45, P<0.001). lnNT-proBNP(3.89±0.90vs6.53±2.03, P<0.001)were higher in patients with HF than those in control subjects. 2. The level of lnSDC4was higher in patients with NYHA functional class Ⅲ-Ⅳ (1.90±0.45) than in patients with NYHA functional class Ⅰ-Ⅱ (1.580.39, P<0.01) and the control subjects (1.47±0.28, P <0.01). Patients with NYHA functional class Ⅰ-Ⅱ had higher SDC4than the control subjects, but the difference didn’t reach statistical significance (p=0.307)3. The level of lnSDC4was higher in patients with LVEF≤40%(1.88±0.45) than in patients with LVEF>40%(1.61±0.41, P<0.05) and the control subjects (1.47±0.28, P<0.05). Patients with LVEF>40%had higher SDC4than the controls, but the difference didn’t reach statistical significance (p=0.12).4. The level of lnSDC4was higher in patients with abnormal LVMI (1.82±0.44) than in patients with normal LVMI (1.47±0.28, P<0.05) and the control subjects (1.64±0.44, P<0.05). Patients with normal LVMI had higher SDC4than the controls, but the difference didn’t reach statistical significance (p=0.058)5. The correlation between SDC4and In NT-proBNP、LVEDd、 LVMI、LVM、NYHA function class were positive, but inversely correlated with LVEF and LVFS.6. Receiver-operator characteristic curves (ROC) for diagnosis of HF showed the area under the curve (AUC) of SDC4was0.70,the best cutoff value was4.31pg/ml and the corresponding sensitivity and specificity were73.4%,67.1%respectively. While the AUC of NT-proBNP was0.88, the best cutoff value was202.50pg/ml and the corresponding sensitivity and specificity were72.6%,97.1%respectively.7. The level of lnSDC4(1.97±0.41vs1.71±0.43, P<0.05)、 lnNT-proBNP (7.38±1.79vs6.40±1.90, P<0.05) was higher in patients with adverse cardiac events than in patients without adverse cardiac events. The area under the curve (AUC) of SDC4for the prediction of cardiac death or re-hospitalization due to heart failure was0.71,while that of NT-proBNP was0.75.Conclusions:1. Serum syndecan-4level was significantly increased in patients with heart failure, relating to the severity of heart failure.2. The level of syndecan-4was correlated positively with that of amino terminal B-type natriuretic peptide (NT-proBNP)3. The level of syndecan-4was correlated positively with LVMI and negatively with left ventricular ejection fraction.4. Serum syndecan-4might predict the diagnosis and prognosis of heart failure.