OBJECTIVE To detect serum level of syndecan-4 protein in patients with chronic congestive heart failure (CHF) and investigate its correlation with New York Heart Association (NYHA) class and echocardiographic parameters. METHODS The concentration of serum syndecan-4 protein was measured by enzyme-linked immunosorbent assay (ELISA) in 40 patients with CHF and 40 healthy controls (NCD), respectively. The parameters such as left ventricle ejection fraction (LVEF), fraction shortening (FS), left ventricle end-diastolic diameter (LVDd), left ventricle end-systolic diameter (LVDs), left ventricle end-diastolic volume (LVEDV) and left ventricle end-systolic volume (LVESV) were detected by echocardiography in 40 patients of CHF. Meanwhile, the patients' cardiac function was graded according to NYHA class. RESULTS The levels of serum syndecan-4 protein significantly increased in CHF group as compared with control group (P<0.01). In CHF group, as the increased grading of NYHA cardiac function, the levels of serum syndecan-4 protein significantly increased (P<0.05). The more upgraded the NYHA grading, the higher level of serum syndecan-4 protein. In bivariate correlations analysis showed that the level of serum syndecan-4 protein was significantly negatively correlated with LVEF and FS (P<0.05) and was significantly positively correlated with LVDd, LVDs, LVEDV and LVESV, respectively (P<0.05). CONCLUSIONS Serum syndecan-4 concentration significantly increased in CHF patients, and it was closely correlated with NYHA class and left ventricle function parameters, so the level of serum syndecan-4 protein may have an important value in detection and surveillance of CHF.