Overhydration is an important factor contributing to LVH in HD patients, and fluid overload is associated with pressure-related echocardiographic parameters, such as LAVI as well as E/e`[34, 35].Syndecan-4 plays a role in a myriad of processes that are involved in the heart failure pathogenesis[12–17, 25, 36].Results of previous studies have demonstrated that syndecan-4 is essential for development of cardiac hypertrophy [9, 15, 25], and syndecan-4 production is increased in the repair, but not undamaged region after myocardial infarction [10]. This evidence concerns the gene SDC4 and cardiac hypertrophy.