Serum Syndecan-4 is a Novel Biomarker for Patients With Chronic Heart Failure

Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
Journal of Cardiology (Impact Factor: 2.78). 03/2011; 57(3):325-32. DOI: 10.1016/j.jjcc.2011.01.012
Source: PubMed


Syndecan-4 is a transmembrane heparan sulfate-carrying glycoprotein that mediates signal transduction pathways activated by growth factors and cell surface receptors, thereby modulating tissue regeneration, angiogenesis, and focal adhesion. The aim of the present study was to determine the clinical use of serum syndecan-4 concentration for diagnosis of heart failure.
Concentration of serum syndecan-4 and other biomarkers of heart failure was measured in 45 patients with heart failure and 21 healthy subjects. Clinical and echocardiographic parameters of cardiac function were recorded.
Serum syndecan-4 concentration significantly increased in proportion to the decrease in ejection fraction (r=-0.599, p<0.001) and increase in the left ventricular (LV) mass index (r=0.315, p<0.05). Serum syndecan-4 concentration was significantly correlated with LV geometrical parameters (i.e. LV mass index, LV end-diastolic volume, and LV dimension), while B-type natriuretic peptide (BNP) was significantly correlated with pressure-related parameters [i.e. early transmitral flow velocity/early diastolic velocity of the mitral valve annulus (E/e'), right ventricular systolic pressure, and left atrial volume index]. Syndecan-4 concentration did not significantly correlate with plasma BNP, transforming growth factor-1, matrix metalloproteinase-2, and tenascin-C concentrations. Serum syndecan-4 concentration could predict cardiac death and re-hospitalization due to heart failure (area under curve, 0.706, p<0.05).
Serum syndecan-4 concentration shows promise as a novel diagnostic and prognostic biomarker for heart failure. Since syndecan-4 correlated with LV geometrical rather than hemodynamic parameters, serum syndecan-4 may represent a biomarker of LV remodeling in the failing heart.

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Available from: Kazuaki Negishi
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    • "Thus, identification of pathophysiological and molecular consequences associated with syndecan-4 shedding could contribute to improved understanding of cardiac immune responses. Levels of circulating syndecan-4 ectodomains are elevated in patients with acute myocardial infarction [17] and chronic heart failure [18], and although large cohort studies are lacking, syndecan-4 has been suggested as a promising novel biomarker for risk-stratification. "
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    • "The efficacy of biomarkers, particularly B-type natriuretic peptide (BNP), in predicting heart failure events has been confirmed in patients with myocardial infarction or dilated cardiomyopathy [6] [7]. However, the clinical utility of BNP in patients with HCM is controversial 8—10. "
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