Abstract
Objectives: We built and validated a new heart failure (HF) prognostic model which integrates cardiopulmonary exercise test (CPET) parameters with easy-to-obtain clinical, laboratory, and echocardiographic variables. Background: HF prognostication is a challenging medical judgment, constrained by a magnitude of uncertainty. Methods: Our risk model was derived from a cohort of 2716 systolic HF patients followed in 13 Italian centers. Median follow up was 1041 days (range 4-5185). Cox proportional hazard regression analysis with stepwise selection of variables was used, followed by cross-validation procedure. The study end-point was a composite of cardiovascular death and urgent heart transplant. Results: Six variables (hemoglobin, Na+, kidney function by means of MDRD, left ventricle ejection fraction [echocardiography], peak oxygen consumption [% pred] and VE/VCO2 slope) out of the several evaluated resulted independently related to prognosis. A score was built from Metabolic Exercise Cardiac Kidney Indexes, the MECKI score, which identified the risk of study end-point with AUC values of 0.804 (0.754-0.852) at 1 year, 0.789 (0.750-0.828) at 2 years, 0.762 (0.726-0.799) at 3 years and 0.760 (0.724-0.796) at 4 years. Conclusions: This is the first large-scale multicenter study where a prognostic score, the MECKI score, has been built for systolic HF patients considering CPET data combined with clinical, laboratory and echocardiographic measurements. In the present population, the MECKI score has been successfully validated, performing very high AUC.
| Original language | English |
|---|---|
| Pages (from-to) | 2710-2718 |
| Number of pages | 9 |
| Journal | International Journal of Cardiology |
| Volume | 167 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2013 |
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Keywords
- Heart failure
- Oxygen consumption
- Prognosis
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score : A multiparametric approach to heart failure prognosis. / Agostoni, Piergiuseppe; Corrà, Ugo; Cattadori, Gaia; Veglia, Fabrizio; La Gioia, Rocco; Scardovi, Angela B.; Emdin, Michele; Metra, Marco; Sinagra, Gianfranco; Limongelli, Giuseppe; Raimondo, Rossella; Re, Federica; Guazzi, Marco; Belardinelli, Romualdo; Parati, Gianfranco; Magrì, Damiano; Fiorentini, Cesare; Mezzani, Alessandro; Salvioni, Elisabetta; Scrutinio, Domenico; Ricci, Renato; Bettari, Luca; Di Lenarda, Andrea; Pastormerlo, Luigi E.; Pacileo, Giuseppe; Vaninetti, Raffaella; Apostolo, Anna; Iorio, Annamaria; Paolillo, Stefania; Palermo, Pietro; Contini, Mauro; Confalonieri, Marco; Giannuzzi, Pantaleo; Passantino, Andrea; Cas, Livio Dei; Piepoli, Massimo F.; Passino, Claudio.
In: International Journal of Cardiology, Vol. 167, No. 6, 2013, p. 2710-2718.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score
T2 - A multiparametric approach to heart failure prognosis
AU - Agostoni, Piergiuseppe
AU - Corrà, Ugo
AU - Cattadori, Gaia
AU - Veglia, Fabrizio
AU - La Gioia, Rocco
AU - Scardovi, Angela B.
AU - Emdin, Michele
AU - Metra, Marco
AU - Sinagra, Gianfranco
AU - Limongelli, Giuseppe
AU - Raimondo, Rossella
AU - Re, Federica
AU - Guazzi, Marco
AU - Belardinelli, Romualdo
AU - Parati, Gianfranco
AU - Magrì, Damiano
AU - Fiorentini, Cesare
AU - Mezzani, Alessandro
AU - Salvioni, Elisabetta
AU - Scrutinio, Domenico
AU - Ricci, Renato
AU - Bettari, Luca
AU - Di Lenarda, Andrea
AU - Pastormerlo, Luigi E.
AU - Pacileo, Giuseppe
AU - Vaninetti, Raffaella
AU - Apostolo, Anna
AU - Iorio, Annamaria
AU - Paolillo, Stefania
AU - Palermo, Pietro
AU - Contini, Mauro
AU - Confalonieri, Marco
AU - Giannuzzi, Pantaleo
AU - Passantino, Andrea
AU - Cas, Livio Dei
AU - Piepoli, Massimo F.
AU - Passino, Claudio
PY - 2013
Y1 - 2013
N2 - Objectives: We built and validated a new heart failure (HF) prognostic model which integrates cardiopulmonary exercise test (CPET) parameters with easy-to-obtain clinical, laboratory, and echocardiographic variables. Background: HF prognostication is a challenging medical judgment, constrained by a magnitude of uncertainty. Methods: Our risk model was derived from a cohort of 2716 systolic HF patients followed in 13 Italian centers. Median follow up was 1041 days (range 4-5185). Cox proportional hazard regression analysis with stepwise selection of variables was used, followed by cross-validation procedure. The study end-point was a composite of cardiovascular death and urgent heart transplant. Results: Six variables (hemoglobin, Na+, kidney function by means of MDRD, left ventricle ejection fraction [echocardiography], peak oxygen consumption [% pred] and VE/VCO2 slope) out of the several evaluated resulted independently related to prognosis. A score was built from Metabolic Exercise Cardiac Kidney Indexes, the MECKI score, which identified the risk of study end-point with AUC values of 0.804 (0.754-0.852) at 1 year, 0.789 (0.750-0.828) at 2 years, 0.762 (0.726-0.799) at 3 years and 0.760 (0.724-0.796) at 4 years. Conclusions: This is the first large-scale multicenter study where a prognostic score, the MECKI score, has been built for systolic HF patients considering CPET data combined with clinical, laboratory and echocardiographic measurements. In the present population, the MECKI score has been successfully validated, performing very high AUC.
AB - Objectives: We built and validated a new heart failure (HF) prognostic model which integrates cardiopulmonary exercise test (CPET) parameters with easy-to-obtain clinical, laboratory, and echocardiographic variables. Background: HF prognostication is a challenging medical judgment, constrained by a magnitude of uncertainty. Methods: Our risk model was derived from a cohort of 2716 systolic HF patients followed in 13 Italian centers. Median follow up was 1041 days (range 4-5185). Cox proportional hazard regression analysis with stepwise selection of variables was used, followed by cross-validation procedure. The study end-point was a composite of cardiovascular death and urgent heart transplant. Results: Six variables (hemoglobin, Na+, kidney function by means of MDRD, left ventricle ejection fraction [echocardiography], peak oxygen consumption [% pred] and VE/VCO2 slope) out of the several evaluated resulted independently related to prognosis. A score was built from Metabolic Exercise Cardiac Kidney Indexes, the MECKI score, which identified the risk of study end-point with AUC values of 0.804 (0.754-0.852) at 1 year, 0.789 (0.750-0.828) at 2 years, 0.762 (0.726-0.799) at 3 years and 0.760 (0.724-0.796) at 4 years. Conclusions: This is the first large-scale multicenter study where a prognostic score, the MECKI score, has been built for systolic HF patients considering CPET data combined with clinical, laboratory and echocardiographic measurements. In the present population, the MECKI score has been successfully validated, performing very high AUC.
KW - Heart failure
KW - Oxygen consumption
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=84883760113&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84883760113&partnerID=8YFLogxK
U2 - 10.1016/j.ijcard.2012.06.113
DO - 10.1016/j.ijcard.2012.06.113
M3 - Article
VL - 167
SP - 2710
EP - 2718
JO - International Journal of Cardiology
JF - International Journal of Cardiology
SN - 0167-5273
IS - 6
ER -