Copyright: ©Author(s) 2026. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See permissions. Published by Baishideng Publishing Group Inc.
World J Clin Pediatr. Jun 9, 2026; 15(2): 116098
Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.116098
Published online Jun 9, 2026. doi: 10.5409/wjcp.v15.i2.116098
Evaluation of heart rate variability in pediatric patients with beta thalassemia major: Cross-sectional study
Esraa A Sorour, Eman M Elaskary, Shimaa Basyoni Elnemr, Adel A Hagag, Nesma Ahmed Kassab, Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, Tanta 31511, Alghrabia, Egypt
Mohammed Al-Beltagi, Department of Paediatrics, University Medical Center, King Abdulla Medical City, Arabian Gulf University, Manama 26671, Manama, Bahrain
Co-first authors: Esraa A Sorour and Eman M Elaskary.
Author contributions: Sorour EA conceptualized and designed the study, coordinated data collection, performed the statistical analysis, interpreted the findings, and drafted the initial manuscript; Elaskary EM contributed to the study design, data acquisition, and critical revision of the manuscript; Sorour EA and Elaskary EM have made crucial and indispensable contributions towards the completion of the project and thus qualified as the co-first authors of the paper; Elnemr SB participated in data interpretation, literature review, and manuscript editing; Hagag AA supervised the clinical evaluation of patients and reviewed the manuscript for important intellectual content; Kassab NA assisted in data entry, tabulation, and preliminary data analysis; Al-Beltagi M provided overall study supervision, critically revised the manuscript for intellectual and clinical accuracy, and approved the final version for publication; all authors have read and approved the final manuscript.
AI contribution statement: We did not use ChatGPT, DeepL, or any similar AI-based writing tools in the preparation of this manuscript. The only tool used was Grammarly, integrated within Microsoft Office, solely for basic grammar and language correction.
Institutional review board statement: The study was reviewed and approved by the Ethical Committee of the Faculty of Medicine, Tanta University, Egypt (No. 36264MS112/3/23). The study was conducted in accordance with the ethical standards of the institutional research committee and with the principles of the Declaration of Helsinki.
Informed consent statement: Written informed consent was obtained from the parents or legal guardians of all participating children prior to enrollment in the study.
Conflict-of-interest statement: The authors declare that they have no conflict of interest related to this study.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement- checklist of items.
Data sharing statement: The data supporting the findings of this study are available from the corresponding author upon reasonable request. The data are not publicly available due to ethical and privacy considerations related to patient confidentiality.
Corresponding author: Mohammed Al-Beltagi, Department of Pediatrics, Faculty of Medicine, Tanta University, No. 1 Hassan Radwan Street, Tanta 31511, Algharbia, Egypt.
Received: November 3, 2025
Revised: December 15, 2025
Accepted: January 29, 2026
Published online: June 9, 2026
Processing time: 192 Days and 11 Hours
Revised: December 15, 2025
Accepted: January 29, 2026
Published online: June 9, 2026
Processing time: 192 Days and 11 Hours
Core Tip
Core Tip: Children with β-thalassemia major may develop cardiac dysfunction long before echocardiographic or clinical evidence appears. This study demonstrates that heart rate variability (HRV) analysis can detect early autonomic imbalance, reflecting subclinical cardiac involvement. Routine HRV monitoring in pediatric thalassemia patients offers a simple, non-invasive method to identify high-risk individuals and initiate preventive measures early, potentially improving cardiac outcomes and survival.