Gabrielli Maurizio, Cucurachi Riccardo, Lamendola Priscilla, Candelli Marcello, Pignataro Giulia, Del Bono Grazia, Franceschi Francesco
From the Department of Emergency, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Department of Cardiovascular Medicine, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy.
Cardiol Rev. 2023;31(5):265-269. doi: 10.1097/CRD.0000000000000444. Epub 2022 Feb 7.
International guidelines define paroxysmal supraventricular tachycardia (PSVT) as all supraventricular tachyarrhythmias other than atrial flutter and atrial fibrillation. Associate symptoms, such as chest pain and dyspnea, and possible ECG changes during arrhythmia, such as ST depression, may suggest to the emergency physician a diagnosis of acute coronary syndrome (ACS), and thus lead to a request for troponin (cTn) level. Here, we provide a comprehensive synthesis covering published literature on the diagnostic and prognostic role of cTn in patients admitted to Emergency Department (ED) for an episode of PSVT. We performed an extensive evaluation article written in English and available in PubMed and Web of Science by using the following Medical Subject Headings (MeSH): "paroxysmal supraventricular tachycardia" AND/OR "supraventricular tachycardia" AND "Troponin" AND "Emergency Department" AND/OR "coronary artery disease". We also performed hand searching of reference lists of selected articles. A total of 17 articles were finally included. There was great variability about study design, setting and criteria for the definition of PSVT and/or type of troponin. Troponin levels were measured frequently (up to 79%) in patients admitted to ED for PSVT. About 30% of them showed cTn elevation. This elevation appears not to be associated with the presence of CAD. However, c-Tn measurements could retain utility in stratifying those with poorer prognosis among PSVT patients with an elevated cardiovascular risk profile.
国际指南将阵发性室上性心动过速（PSVT）定义为除心房扑动和心房颤动以外的所有室上性快速性心律失常。相关症状，如胸痛和呼吸困难，以及心律失常期间可能出现的心电图变化，如ST段压低，可能会使急诊医生怀疑为急性冠状动脉综合征（ACS），从而要求检测肌钙蛋白（cTn）水平。在此，我们全面综合了已发表的关于cTn在因PSVT发作而入住急诊科（ED）患者中的诊断和预后作用的文献。我们通过使用以下医学主题词（MeSH）在PubMed和Web of Science上对英文撰写的评估文章进行了广泛检索：“阵发性室上性心动过速”和/或“室上性心动过速”以及“肌钙蛋白”和“急诊科”和/或“冠状动脉疾病”。我们还对所选文章的参考文献列表进行了手工检索。最终共纳入17篇文章。关于PSVT的研究设计、背景以及定义标准和/或肌钙蛋白类型存在很大差异。因PSVT入住ED的患者中经常检测肌钙蛋白水平（高达79%）。其中约30%显示cTn升高。这种升高似乎与CAD的存在无关。然而，cTn检测在对心血管风险较高的PSVT患者中预后较差的患者进行分层时可能仍有用处。
