The serum syndecan-1 level as a biomarker of endothelial injury and its clinical implications in canine myxomatous mitral valve disease

抄録

Syndecan-1, a component of the endothelial glycocalyx, is a marker of endothelial injury. In human congestive heart failure, an elevated serum syndecan-1 level is associated with decreased cardiac function, renal impairment, and poor prognosis. However, no studies have reported the syndecan-1 level in dogs with myxomatous mitral valve disease (MMVD). In this study, the aims were to evaluate the effect of MMVD on the syndecan-1 level and to investigate its clinical utility by examining its association with the pathophysiology and severity of MMVD. The syndecan-1 level was measured in cryopreserved samples from 65 dogs with MMVD and nine healthy dogs. Clinical, laboratory, and imaging data were retrospectively retrieved. Associations between the syndecan-1 level and clinical and diagnostic findings were retrospectively analyzed. The syndecan-1 level was higher in dogs with MMVD: median 4.73 ng/ml than in the control group, median 3.64 ng/ml (P = 0.0004). The presence of MMVD was significantly associated with an increase in the syndecan-1 level (P = 0.033). There was no association between the syndecan-1 level and cardiac dysfunction or structural abnormalities. However, there was an association between an elevated syndecan-1 level and ongoing pulmonary edema (P = 0.045). The syndecan-1 level was significantly higher in dogs with MMVD, suggesting that endothelial injury has a role in the pathophysiology of MMVD. Multivariate regression analysis suggested a potential association between serum syndecan-1 levels and pulmonary edema; however, this finding requires validation in a large cohort.