{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:07:50Z","timestamp":1788480470475,"version":"build-2803163510"},"reference-count":49,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2019,6,1]],"date-time":"2019-06-01T00:00:00Z","timestamp":1559347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["15ek0109127h0001"],"award-info":[{"award-number":["15ek0109127h0001"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,6,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Rationale<\/jats:title>\n                    <jats:p>To detect pulmonary arterial hypertension (PAH) at any early stage is a promising approach to optimize the outcome.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the impact of school ECG-based screening on detecting idiopathic or heritable (I\/H)-PAH in the general pediatric population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This was a nationwide survey of patients with I\/H-PAH newly diagnosed at 3 months to 18 years of age in Japan during 2005\u20132012.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements and Main Results<\/jats:title>\n                    <jats:p>Eighty-seven eligible patients (age range, 1\u201316 yr) were recruited. Among 68 (78%) patients diagnosed at greater than or equal to 6 years of age (the age of the first ECG-based screening), 28 (41%) were detected by the ECG-based screening (screening group) and 40 (59%) were recognized by their symptoms (n\u2009=\u200937) or coincidental occasions (n\u2009=\u20093; nonscreening 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\u2009&amp;lt;\u20090.001), plasma brain natriuretic peptide level was lower (149\u2009\u00b1\u2009290 vs. 398\u2009\u00b1\u2009559 pg\/ml; P\u2009=\u20090.045), and 6-minute-walk distance was longer (420\u2009\u00b1\u2009109 vs. 327\u2009\u00b1\u2009104 m; P\u2009&amp;lt;\u20090.001) than the nonscreening group, despite similar values in mean pulmonary artery pressure (58\u2009\u00b1\u200917 vs. 61\u2009\u00b1\u200917 mm Hg; P\u2009=\u20090.42) and pulmonary vascular resistance index (18\u2009\u00b1\u20098 vs. 21\u2009\u00b1\u200911 Wood units\u2009\u22c5\u2009m2; P\u2009=\u20090.24) between groups. The proportion of patients on intravenous epoprostenol at the final visit was lower in the screening group than the nonscreening group (14% vs. 50; P\u2009=\u20090.004).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings suggest that the ECG-based screening detects a unique subpopulation of pediatric patients with I\/H-PAH that is associated with already established pulmonary hypertension but without obvious right heart failure and warrants investigating the prognostic significance of this system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1164\/rccm.201802-0375oc","type":"journal-article","created":{"date-parts":[[2018,11,14]],"date-time":"2018-11-14T17:47:52Z","timestamp":1542217672000},"page":"1397-1406","source":"Crossref","is-referenced-by-count":32,"title":["Detection of Pediatric Pulmonary Arterial Hypertension by School Electrocardiography Mass Screening"],"prefix":"10.1093","volume":"199","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8069-5751","authenticated-orcid":false,"given":"Hirofumi","family":"Sawada","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Mie University School of Medicine, Mie, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6038-8161","authenticated-orcid":false,"given":"Yoshihide","family":"Mitani","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Mie University School of Medicine, Mie, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomotaka","family":"Nakayama","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toho University Omori Medical Center, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroyuki","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Keio University School of Medicine, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shigetoyo","family":"Kogaki","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Osaka University School of Medicine, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takehiro","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, National Cerebral and Cardiovascular Center, Osaka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fukiko","family":"Ichida","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Toyama University School of Medicine, Toyama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuo","family":"Ono","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Shizuoka Children\u2019s Hospital, Shizuoka, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshio","family":"Nakanishi","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Tokyo Women\u2019s Medical University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shozaburo","family":"Doi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Tokyo Medical and Dental University, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shiro","family":"Ishikawa","sequence":"additional","affiliation":[{"name":"Department of Pediatric Cardiology, Fukuoka Children\u2019s Hospital, Fukuoka, Japan; 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