{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T14:05:27Z","timestamp":1791295527954,"version":"4.1.0"},"reference-count":22,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:00:00Z","timestamp":1782950400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Arrhythmia"],"published-print":{"date-parts":[[2026,8]]},"abstract":"ABSTRACT<\/jats:title>\n \n Background<\/jats:title>\n T\u2010wave amplitude variability (TAV), a marker of beat\u2010to\u2010beat ventricular repolarization instability, has been proposed as a potential risk marker for adverse cardiovascular outcomes, but its prognostic value remains unclear.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n This meta\u2010analysis aimed to quantitatively synthesize evidence on the association between elevated TAV and adverse cardiovascular outcomes.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n A systematic literature search of PubMed, Embase, and the Cochrane Library was conducted. Observational studies reporting adjusted effect estimates for the association between TAV and adverse cardiovascular outcomes were included, and separate meta\u2010analyzes were conducted according to effect measures (hazard ratios [HRs] or odds ratios [ORs]) and exposure definition. Effect estimates were pooled using a random\u2010effects model. Statistical heterogeneity was assessed using the Q statistic and\n I<\/jats:italic>\n 2<\/jats:sup>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Seven studies involving 1366 patients were included. HR\u2010based analyzes (\n n<\/jats:italic>\n \u2009=\u20093) showed that elevated TAV was significantly associated with an increased risk of adverse outcomes, including mortality and ventricular tachyarrhythmias (pooled HR 2.51, 95% CI 1.57\u20134.00;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u20097%). In contrast, OR\u2010based analyzes showed no statistically significant association between TAV and ventricular tachyarrhythmias, whether evaluated as categorical (high vs. low TAV: pooled OR 3.82, 95% CI 0.87\u201316.84;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200975%) or continuous variable (per 1\u2013\u03bcV increase: pooled OR 1.11, 95% CI 0.94\u20131.30;\n I<\/jats:italic>\n 2<\/jats:sup>\n \u2009=\u200970%).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Elevated TAV is associated with an increased risk of adverse cardiovascular outcomes in HR\u2010based analyzes, supporting its potential utility as a marker of repolarization instability for longitudinal risk stratification. In contrast, its association with ventricular tachyarrhythmias was not significant in OR\u2010based analyzes, which showed substantial heterogeneity.<\/jats:p>\n \n Trial Registration:<\/jats:bold>\n PROSPERO: CRD420251171782.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/joa3.70411","type":"journal-article","created":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T09:16:53Z","timestamp":1782983813000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Prognostic Significance of T\u2010Wave Amplitude Variability for Adverse Cardiovascular Outcomes: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"42","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0767-3780","authenticated-orcid":false,"given":"Yoshihiro","family":"Sobue","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Fujita Health University Bantane Hospital Nagoya Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9013-9223","authenticated-orcid":false,"given":"Kazuya","family":"Takeda","sequence":"additional","affiliation":[{"name":"Graduate School of Health Sciences Fujita Health University Graduate School Toyoake Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3128-6421","authenticated-orcid":false,"given":"Mari","family":"Amino","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokai University Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichiro","family":"Yoshioka","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine Tokai University Kanagawa Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomohide","family":"Ichikawa","sequence":"additional","affiliation":[{"name":"Department of Cardiology Matsumoto Kyoritsu Hospital Matsumoto Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiichi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Fujita Health University Bantane Hospital Nagoya 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