Author(s)

Huan Zeng ¹, Ying Li ¹

Affiliation(s)

¹ Department of Electrocardiographic Diagnosis. The First College of Clinical Medical Science, China Three Gorges University & Yichang, Central People's Hospital, Yichang, Hubei, 443003, China

Corresponding Author

Ying Li

ABSTRACT

To evaluate the clinical application value of 24-hour dynamic electrocardiography (DCG) and heart rate variability (HRV) indices in the early assessment of myocardial damage in children with Mycoplasma pneumoniae pneumonia (MPP), this retrospective analysis of 120 pediatric patients with Mycoplasma pneumoniae pneumonia (MPP) evaluated the diagnostic utility of 24-hour dynamic electrocardiography (DCG) and heart rate variability (HRV) indices for the early assessment of myocardial damage. Subjects were stratified into myocardial damage (n=48) and non-damage (n=72) cohorts based on clinical and biomarker criteria. DCG demonstrated a significantly higher abnormality detection rate of 56.67% compared to 19.17% for routine ECG  (x²=35.42, P<0.001). while all HRV time-domain parameters, including SDNN, SDANN, RMSSD, and pNN50, were significantly attenuated in the myocardial damage group (all P<0.001). Receiver operating characteristic (ROC) curve analysis for SDNN yielded an area under the curve (AUC) of 0.837; at an optimal cut-off value of 95.95ms, the index provided 90.3% specificity and 64.6% sensitivity for predicting myocardial involvement. These findings indicate that DCG is superior to routine ECG in detecting occult cardiac abnormalities and that diminished HRV indices reflect significant autonomic dysfunction, identifying SDNN as a reliable, non-invasive tool for early risk stratification of parenchymal myocardial damage in pediatric MPP.

KEYWORDS

Mycoplasma pneumoniae pneumonia; Myocardial damage; Dynamic electrocardiogram; Heart rate variability; ROC curve; Children

CITE THIS PAPER

Huan Zeng, Ying Li. Dynamic Electrocardiogram Assessment and Clinical Value of Myocardial Damage in Children with Mycoplasma Pneumoniae Pneumonia. MEDS Clinical Medicine (2026). Vol. 7, No.2, 37-44. DOI: http://dx.doi.org/10.23977/medsc.2026.070206.

REFERENCES

[1] Li C M, Gu L, Yin S J, et al. Age-specific Mycoplasma pneumoniae pneumonia-associated myocardial damage in children[J]. Journal of international medical research, 2013, 41(5): 1716-1723.
[2] Ni T, Zhao F. Predicting myocardial damage in children with mycoplasma pneumoniae pneumonia: a retrospective case-control study[J]. BMC Infectious Diseases, 2025, 25(1): 733.
[3] Har Shefi T, Oster Y, Gordon O, et al. Cardiac manifestations of Mycoplasma pneumoniae infections: a cohort study 2007–2024[J]. Clinical Infectious Diseases, 2025, 81(5): e269-e276.
[4] Li W, Liu T, Yao M, et al. Effect of interesting respiratory rehabilitation training for the treatment of refractory Mycoplasma pneumoniae pneumonia in children[J]. BMC Infectious Diseases, 2023, 23(1): 561.
[5] Chen S, Ke S, Vinturache A, et al. Pulmonary embolism associated with Mycoplasma pneumoniae pneumonia in children[J]. Pediatric Pulmonology, 2023, 58(12): 3605-3608.

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