School electrocardiography, which is peculiar to Japan, was found to be useful for early diagnosis of idiopathic pulmonary arterial hypertension (IPAH).Associate Professor Yoshihide Mitani of Mie University Hospital and Lecturer Hirofumi Sawada of Graduate School of Medicine proved by the result of the national survey.

 Idiopathic pulmonary arterial hypertension (IPAH) is a rare disease that affects 100 in 1 million children annually.Pulmonary hypertension in which peripheral pulmonary arteries contract and occlude, and no other cause is found. Since the 2000s, the development of effective therapeutic agents has improved the 5-year survival rate to about 75%, but it is a disease with a poor prognosis.Early-diagnosed cases tend to have a better post-treatment prognosis than late-diagnosis cases.However, the main symptoms such as shortness of breath and tiredness are difficult to notice and difficult to diagnose at an early stage.Therefore, early diagnosis has not made much progress in the last 20 years or more.

 In Japan, school cardiac examinations have been conducted in some areas of the Kansai region since 1954. In 1995, due to the revision of the School Insurance Law Enforcement Regulations, all first graders of elementary schools, junior high schools, and high schools nationwide were required to have an electrocardiogram.However, although the electrocardiogram reflects right ventricular hypertrophy, it was unclear whether pulmonary hypertension could be diagnosed early.

 Therefore, we conducted a national survey from 2005 to 2012 to investigate whether pulmonary hypertension can be diagnosed at an early stage.As a result, among the ages of patients diagnosed with idiopathic pulmonary arterial hypertension, the age of undergoing school examination was outstanding, demonstrating its usefulness.It was also found that the cases found by screening were often milder than those found due to symptoms, etc., and the prognosis was better.

 With this discovery, it is expected that the progress of early diagnosis by improving the interpretation of school electrocardiography and the discussion and dissemination of school electrocardiography, which is a system unique to Japan, outside Japan will be expected in the future.

Paper information:[American Journal of Respiratory and Critical Care Medicine] Detection of Pediatric Pulmonary Arterial Hypertension by School Electrocardiography Mass Screening

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