Syndecan-4 as a Biomarker in Patients With Chagas Disease

Validation of Syndecan-4 as a Biomarker for Determining Patients Prognosis With Chagas Disease.

The purpose of this study is to analyze the efficacy of syndecan-4 as a biomarker on the Chagas Disease prognosis. This analysis will be done through the correlation between the plasmatic levels of this molecule with functional and laboratory tests.

Increased serum levels of syndecan-4 have been correlated to acute myocardial infarction and chronic heart failure, suggesting that this molecule can be an important biomarker in heart diseases. In spite of that, there are no studies that have investigated the role of this molecule in chronic chagasic cardiomyopathy yet.

In this project, our objective is to demonstrate the potential role of syndecan-4 in the prognosis of chronic chagasic cardiomyopathy, seeking a better fitting of the treatment through the identification of patients with the worse prognosis.

The patients included in the study must at first sign the written consent. They shall be accompanied in the specialized outpatient clinics for Chagas disease - Hospital São Rafael - Centro de Biotecnologia e Terapia Celular. They will be submitted to several tests, including:

• Collection of Blood samples for biochemical analysis;
• Electrocardiogram;
• Holter Electrocardiogram;
• Echocardiogram;
• Treadmill Test;
• X-Ray Imaging;
• Magnetic Resonance Imaging;
• Evaluation of the quality of life through the application of questionnaires (SF 36 and the Minnesota Living With Heart Failure Questionnaire).

Inclusion Criteria:

• Chagas disease diagnosis confirmed by 2 different serologies
• Diagnosis of Chagas disease in both forms: indeterminate and cardiac ones, with and without ventricular dysfunction.

Exclusion Criteria:

• Significant valve disease defined as aortic stenosis with a gradient of VE/Ao > 50 mmHg
• Mitral stenosis with a valve area inferior than 1,5 cm2
• Superior or moderated aortic and/or mitral regurgitation
• Chronic use of immunosuppressive agents
• Dialysis treatment of terminal renal failure
• Fever on the last 48 hours or evidence of systemic infection in activity according to the definition of sepsis of the ACCP/SCCM (American College os Chest Physicians/Society of Critical Care Medicine)
• Current abusive use of alcohol or illicit drugs (Based on the DSM IV)
• Any other comorbidities that impact patient's survival within the next 2 years
• Liver disease in activity
• Continuous use of steroids as treatment for COPD
• Hematologic, neoplastic or bone diseases
• Homeostasis disturbances
• Inflammatory diseases or chronic infectious diseases