Correlation of left ventricular systolic function assessed by automated cardiac motion quantification in children with mycoplasma pneumonia with alveolar mycoplasma DNA levels

doi:10.3877/cma.j.issn.1672-6448.2025.04.012

Abstract

Abstract:

Objective

To evaluate the left ventricular systolic function in children with mycoplasma pneumoniae pneumonia （MPP） using echocardiographic automated cardiac motion quantification （aCMQ）technology， and to explore its correlation with the load of mycoplasma pneumoniae DNA in bronchoalveolar lavage fluid （BALF MP-DNA）.

Methods

A retrospective study was conducted on 56 children with MPP admitted to the Children's Medical Center of Tianxin Pavilion， Hunan Provincial People's Hospital， from October 2023 to June 2024.Additionally， 51 children undergoing routine health check-ups or normal physical examinations were selected as controls.The 56 MPP children were further divided into two subgroups based on the presence or absence of abnormal serum high-sensitivity cardiac troponin I （hs-CTnI）： MPP-A group consisted of 37 children with abnormal hs-CTnI levels， and MPP-B group included 19 children with normal hs-CTnI levels.Routine echocardiographic parameters were measured in all the three groups， and left ventricular myocardial strain indices were assessed using aCMQ technology.Differences in these indices among the three groups were compared.The diagnostic efficacy of left ventricular strain indices was evaluated using receiver operating characteristic （ROC）curves， and the correlation between these indices and BALF MP-DNA load was analyzed.

Results

There were no significant differences in routine echocardiographic parameters among the three groups （all P＞0.05）.The left ventricular longitudinal strain indices ［global longitudinal strain （LVGLS）， apical four-chamber longitudinal strain（AP4LS）， apical three-chamber longitudinal strain （AP3LS）， and apical two-chamber longitudinal strain （AP2LS）］in the MPP-A group were significantly lower than those of the MPP-B group and the control group （all P＜0.05）.However， no significant differences were observed in these indices between the MPP-B group and the control group （all P＞0.05）.Similarly， no significant differences were found in left ventricular circumferential strain indices ［global circumferential strain （LVGCS）， basal short-axis circumferential strain （SAXBCS）， mid short-axis circumferential strain （SAXMCS）， and apical short-axis circumferential strain （SAXACS）］ among the three groups（all P＞0.05）.LVGLS， AP4LS， AP3LS， and AP2LS all demonstrated the ability to predict early left ventricular systolic dysfunction in MPP children， with area under the curve （AUC） values of 0.929， 0.784， 0.840， and 0.852，respectively.Among them， LVGLS exhibited the highest predictive value （P＜0.05）.The MP-DNA load in MPP children was linearly and negatively correlated with the absolute values of LVGLS， AP2LS， AP3LS， and AP4LS（r =-0.453， -0.443， -0.429， and -0.347， respectively， all P＜0.05）.

Conclusion

The left ventricular longitudinal strain indices obtained using aCMQ technology can accurately and objectively evaluate left ventricular systolic function in MPP children.Among these indices， LVGLS holds higher clinical value for assessing myocardial injury in MPP children.The correlation between left ventricular longitudinal strain index and BALF MP-DNA load provides a new perspective for explaining the mechanism of MPP's impact on the cardiovascular system.

Key words: Automated cardial motion quantification, Speckle tracking technique, Echocardiography, Mycoplasma pneumonia, Left ventricular systolic function

Pin Tan, Juanjuan Xie, Xiangdang Long, Kun Ao, Ping Zhang, Yonghua Yuan. Correlation of left ventricular systolic function assessed by automated cardiac motion quantification in children with mycoplasma pneumonia with alveolar mycoplasma DNA levels[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2025, 22(04): 360-367.

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URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2025.04.012

https://chaosheng.cma-cmc.com.cn/EN/Y2025/V22/I04/360

Figures/Tables 9

组别	例数	男性［例（%）］	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI（kg/cm²）	心率（次/min）	体温（℃）	LDH（U/L）	CK-MB（U/L）	hs-CTnI（ng/ml）
MPP-A 组	37	20（54.1）	8.00±2.48	15.7（14.6，19.1）	110（86，118）^a	36.9（36.5，37.6）^a	349.7（291.2，454.4）^a	30.0（17.0，45.0）^a	0.020（0.016，0.030）
MPP-B 组	19	8（42.1）	7.26±1.73	16.5（14.6，19.1）	99.5（84.2，110.8）^a	36.7（36.7，37.7）^a	304.4（265.9，403.5）^a	24.5（15.0，36.1）^a	0.005（0.003，0.009）
对照组	51	30（58.8）	8.43±3.00	16.0（14.9，18.5）	77（69，83）	36.5（36.2，36.5）	198.0（169.0，209.0）	15（13，16）
统计值		χ ²=1.559	F=1.693	H=0.541	H=47.929	H=33.851	H=75.495	H=22.925	Z=-6.092
P值		0.471	0.193	0.462	＜ 0.001	＜ 0.001	＜ 0.001	＜ 0.001	＜0.001

组别	例数	男性［例（%）］	年龄（岁， $\overset{ˉ}{x}$ ± s ）	BMI（kg/cm²）	心率（次/min）	体温（℃）	LDH（U/L）	CK-MB（U/L）	hs-CTnI（ng/ml）
MPP-A 组	37	20（54.1）	8.00±2.48	15.7（14.6，19.1）	110（86，118）^a	36.9（36.5，37.6）^a	349.7（291.2，454.4）^a	30.0（17.0，45.0）^a	0.020（0.016，0.030）
MPP-B 组	19	8（42.1）	7.26±1.73	16.5（14.6，19.1）	99.5（84.2，110.8）^a	36.7（36.7，37.7）^a	304.4（265.9，403.5）^a	24.5（15.0，36.1）^a	0.005（0.003，0.009）
对照组	51	30（58.8）	8.43±3.00	16.0（14.9，18.5）	77（69，83）	36.5（36.2，36.5）	198.0（169.0，209.0）	15（13，16）
统计值		χ ²=1.559	F=1.693	H=0.541	H=47.929	H=33.851	H=75.495	H=22.925	Z=-6.092
P值		0.471	0.193	0.462	＜ 0.001	＜ 0.001	＜ 0.001	＜ 0.001	＜0.001

组别	例数	LVIDd（mm）	LVIDs（mm）	IVSd（mm）	LVPWd（mm）	LVEF（%）
MPP-A 组	37	37.00（34.00，38.00）	22.00（22.00，24.00）	5.80（5.50，6.20）	5.90（5.60，6.20）	68.00（64.00，70.00）
MPP-B 组	19	37.00（35.00，39.75）	23.50（22.00，25.75）	6.00（5.60，6.50）	6.00（5.80，6.30）	69.00（66.00，70.00）
对照组	51	38.00（35.00，41.00）	24.00（22.00，26.00）	6.10（5.60，6.50）	6.00（5.50，6.50）	68.00（66.00，70.00）
H值		3.094	2.692	2.232	1.348	0.860
P值		0.213	0.271	0.260	0.510	0.650

组别	例数	AP4LS	AP3LS	AP2LS	LVGLS
MPP-A 组	37	-20.91±1.22 ^a	-20.27±1.39 ^a	-20.21±1.53 ^a	-20.19±1.13 ^a
MPP-B 组	19	-23.09±1.34	-22.94±1.77	-23.36±1.82	-23.10±1.23
对照组	51	-23.27±1.89	-23.79±1.74	-23.79±2.22	-23.63±1.10
F值		25.571	51.005	38.906	103.752
P值		＜ 0.001	＜ 0.001	＜ 0.001	＜ 0.001

组别	例数	SAXBCS	SAXMCS	SAXACS	LVGCS
MPP-A 组	37	-29.95（-29.25，-31.10）	-29.55（-28.90，-30.60）	-30.30（28.90，33.45）	-29.95（-29.30，-31.10）
MPP-B 组	19	-29.10（-28.75，-30.30）	-29.80（-28.60，-32.05）	-29.00（-28.30，-30.45）	-28.80（-29.40，-30.65）
对照组	51	-29.80（-28.40，-32.30）	-30.30（-29.10，-32.00）	-31.10（-29.10，-34.50）	-30.40（-29.40，-32.10）
H值		0.990	0.947	1.583	-1.594
P值		0.375	0.391	0.210	0.331

应变指标	AUC	95%CI	P值	敏感度	特异度	最佳截断值（%）
AP4LS	0.784	0.654 ～ 0.883	＜ 0.001	0.622	0.842	-21.55
AP3LS	0.840	0.718 ～ 0.924	＜ 0.001	0.757	0.737	-20.15
AP2LS	0.852	0.732 ～ 0.933	＜ 0.001	0.811	0.842	-20.45
LVGLS	0.929	0.827 ～ 0.980	＜ 0.001	0.919	0.789	-20.30

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