title: Usefulness of Continuous 24-hour Ventricular Late Potential to Predict Prognosis in Patients with Heart Failure.
abstract: OBJECTIVE
  An estimated 50,000 patients have heart failure (HF) in Japan, and the left ventricular ejection fraction (LVEF) is the typical predictor of prognosis. The identification of a noninvasive marker to predict most high-risk patients is urgently needed. This study aimed to log the continuous ventricular late potential (LP) by using high-resolution ambulatory monitoring in patients with HF with non-sustained ventricular tachycardia, and determine the association between the LP variation and prognosis.
  
  
  METHODS
  The 90 hospitalized patients were classified into cardiogenic death (n = 10) and non-death (n = 80) groups. The LVEF, LP, and coefficient of variation (CV) of the filtered QRS (fQRS), and low-amplitude signal < 40 µV for the terminal QRS portion of (LAS40) of both groups were evaluated. The maximum fQRS over 24 h was defined as the maximum fQRS (Max-fQRS).
  
  
  RESULTS
  The results were as follows: (1) cardiogenic death occurred in 32% (10/31 patients) with an LVEF ≤ 45% and a Max-fQRS ≤ 114 ms; (2) cardiogenic death occurred in 38% (10/26 patients) with a LAS40-CV ≥ 0.09; and (3) using LVEF, Max-fQRS, and LAS40-CV as the three predictors, the specificity and accuracy were 83% and 82%, respectively, with an odds ratio of 12.3.
  
  
  CONCLUSIONS
  LAS40 variations and increases might be new risk indicators of prognosis.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Matsuzaki
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa 259-1193, Japan. ko1@is.icc.u-tokai.ac.jp.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Yoshioka
authors.forename: Mari
authors.initials: M
authors.lastname: Amino
authors.forename: Makiyoshi
authors.initials: M
authors.lastname: Shima
authors.forename: Tadashi
authors.initials: T
authors.lastname: Hashida
authors.forename: Daisuke
authors.initials: D
authors.lastname: Fujibayashi
authors.forename: Shigetaka
authors.initials: S
authors.lastname: Kanda
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Kobayashi
authors.forename: Teruhisa
authors.initials: T
authors.lastname: Tanabe
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
mesh_terms: D000200:Action Potentials; D000368:Aged; D000369:Aged, 80 and over; D003643:Death; D005260:Female; D006333:Heart Failure / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology; D006352:Heart Ventricles / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D011237:Predictive Value of Tests; D011379:Prognosis; D012306:Risk; D012680:Sensitivity and Specificity; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology