St. Louis has fallen behind  Wisconsin,  Indianapolis, Cincinnati and Detroit  in its reputation as a source for health-care venture capital deals, according to a new survey by BioEnterprise.

The Cleveland-based firm asked 45 venture capitalists about the dealmaking climate in various parts of the Midwest. On a scale of 1 to 10, where 10 is the strongest, St. Louis scored 4.56, down almost a full point from the 2006 ranking of 5.53. Chicago also showed what the survey called a “significant” loss of reputation.

 In BioEnterprise’s 2006 survey, St. Louis had the fourth-highest ranking among 12 Midwestern regions, trailing only Minneapolis, Cleveland and Pittsburgh. St. Louis fell to 8th place in the 2007 survey.

What’s more, the ranking may reflect less money flowing  in our  direction. “Not surprisingly, the 2007 survey results mostly reflect what we have seen in terms of actual venture investing in the Midwest,” Baiju R. Shah, president of BioEnterprise, says in a news release.