Detection of Pediatric Pulmonary Arterial Hypertension by School Electrocardiography Mass Screening

Rationale: To detect pulmonary arterial hypertension (PAH) at any early stages is a promising approach to optimize the outcome. Objectives: To investigate the impact of school electrocardiography(ECG)-based screening on detecting idiopathic or heritable (I/H)-PAH in general pediatric population. Methods: A nationwide survey of I/H-PAH patients newly diagnosed at 3 months-18years of agein Japanduring 2005-12. Measurements and Main Results: Eighty-seven eligible patients (age range: 1-16 years) were recruited. Among 68 (78%) patients diagnosed at ≥6 years of age (the age of the first ECG-based screening), 28 (41%) were detected by the ECG-based screening (Screening group), 40 (59%) were recognized by their symptoms (n=37) or coincidental occasions (n=3) (Non-screening group). In the Screening group, the proportion of patients in World Health Organization functional class I/II at diagnosis was higher (96% vs 60, p<.001), plasma brain natriuretic peptidelevel was lower (149±290 pg/ml vs 398±559, p=.045) an...