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

BACKGROUND

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.

METHODS

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.

RESULTS

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.

CONCLUSIONS

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.

[Medical education and health promotion in a day nursery institution]

PURPOSE

The authors present a community work experience in a 410 children Catholic day nursery institution.

METHODS

Through non-structured interview and play, clinical-epidemiological observation and a survey of the health needs of three months to six years old children were made.

RESULTS

Four relevant themes were identified for the population: hygiene, oral health, ocular health and substance abuse in some family members. In order to deal with these matters, an interactive educational program was organized which included acting activities, films, competitions and laboratory activities with artificial anatomic shapes.

CONCLUSION

These activities give the medical student the opportunity to get acquainted with the not very well known social reality and be committed to the public health.