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

Ticiana Ferreira Larocca,Jorge Andion Torreão,Ricardo Ribeiro Dos Santos,Moisés Imbassahy Moreira,Bruno Solano De Freitas Souza,Carolina Thé Macêdo,Alessandra Carvalho Caldas,Milena Botelho Pereira Soares,Alexandre Schaer Carvalho Da Silva,Márcia Noya-Rabelo,Juliana Fraga Vasconcelos,Luís Cláudio Lemos Correia,Edecio Cunha-Neto

doi:10.1371/journal.pone.0189408

Abstract

BackgroundSyndecan-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.MethodsThis 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.ResultsSyndecan-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.ConclusionsOur 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.

Highlights

Chagas disease (CD), caused by infection with the protozoan parasite Trypanosoma cruzi, is a major public health problem in Latin America [1] and is becoming an emerging problem in non-endemic areas due to population migration [2,3]
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)
Our results demonstrate the lack of correlations between serum syndecan-4, myocardial fibrosis and cardiac dysfunction in subjects with Chagas disease

Summary

Introduction

Chagas disease (CD), caused by infection with the protozoan parasite Trypanosoma cruzi, is a major public health problem in Latin America [1] and is becoming an emerging problem in non-endemic areas due to population migration [2,3]. The hallmark of CCC is the presence of a multifocal inflammatory reaction leading to myocardial fibrosis, often followed by ventricular dysfunction and arrhythmias [5,7,8]. At this disease stage, there is no effective treatment other than heart transplantation. Since the cardiac form of Chagas disease occurs in approximately 30% of the infected patients, and usually develops during 10–30 years after the acute phase, it is of great interest to identify biomarkers that might be used for early detection of cardiac involvement [6]. 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

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Conclusion