The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

Ugo Corra', Piergiuseppe Agostoni, Andrea Giordano, Gaia Cattadori, Elisa Battaia, Rocco La Gioia, Angela Beatrice Scardovi, Michele Emdin, Marco Metra, Gianfranco Sinagra, Giuseppe Limongelli, Rosa Raimondo, Federica Re, Marco Guazzi, R. Belardinelli, Gianfranco Parati, Damiano Magrì, Cesare Fiorentini, Mariantonietta Cicoira, Elisabetta Salvioni & 15 others Marta Giovannardi, Fabrizio Veglia, Alessandro Mezzani, Domenico Scrutinio, Andrea Di Lenarda, Roberto Ricci, Anna Apostolo, Anna Maria Iorio, Stefania Paolillo, Pietro Palermo, Mauro Camillo Contini, Corrado Vassanelli, Claudio Passino, Pantaleo Giannuzzi, Massimo F. Piepoli

Research output: Contribution to journalArticle

Abstract

Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF <40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p <0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.

Original languageEnglish
Pages (from-to)1067-1072
Number of pages6
JournalInternational Journal of Cardiology
Volume203
DOIs
Publication statusPublished - Jan 15 2016

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Validation Studies
Exercise Test
Heart Failure
Kidney
Heart Transplantation
Heart Ventricles
Mortality
Diet Therapy
Oxygen Consumption
Area Under Curve
Prescriptions
Hemoglobins
Heart Rate
Sodium
Exercise
Equipment and Supplies
Population

Keywords

  • Heart failure
  • Prognosis, score

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study. / Corra', Ugo; Agostoni, Piergiuseppe; Giordano, Andrea; Cattadori, Gaia; Battaia, Elisa; La Gioia, Rocco; Scardovi, Angela Beatrice; Emdin, Michele; Metra, Marco; Sinagra, Gianfranco; Limongelli, Giuseppe; Raimondo, Rosa; Re, Federica; Guazzi, Marco; Belardinelli, R.; Parati, Gianfranco; Magrì, Damiano; Fiorentini, Cesare; Cicoira, Mariantonietta; Salvioni, Elisabetta; Giovannardi, Marta; Veglia, Fabrizio; Mezzani, Alessandro; Scrutinio, Domenico; Di Lenarda, Andrea; Ricci, Roberto; Apostolo, Anna; Iorio, Anna Maria; Paolillo, Stefania; Palermo, Pietro; Contini, Mauro Camillo; Vassanelli, Corrado; Passino, Claudio; Giannuzzi, Pantaleo; Piepoli, Massimo F.

In: International Journal of Cardiology, Vol. 203, 15.01.2016, p. 1067-1072.

Research output: Contribution to journalArticle

Corra', U, Agostoni, P, Giordano, A, Cattadori, G, Battaia, E, La Gioia, R, Scardovi, AB, Emdin, M, Metra, M, Sinagra, G, Limongelli, G, Raimondo, R, Re, F, Guazzi, M, Belardinelli, R, Parati, G, Magrì, D, Fiorentini, C, Cicoira, M, Salvioni, E, Giovannardi, M, Veglia, F, Mezzani, A, Scrutinio, D, Di Lenarda, A, Ricci, R, Apostolo, A, Iorio, AM, Paolillo, S, Palermo, P, Contini, MC, Vassanelli, C, Passino, C, Giannuzzi, P & Piepoli, MF 2016, 'The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study', International Journal of Cardiology, vol. 203, pp. 1067-1072. https://doi.org/10.1016/j.ijcard.2015.11.075
Corra', Ugo ; Agostoni, Piergiuseppe ; Giordano, Andrea ; Cattadori, Gaia ; Battaia, Elisa ; La Gioia, Rocco ; Scardovi, Angela Beatrice ; Emdin, Michele ; Metra, Marco ; Sinagra, Gianfranco ; Limongelli, Giuseppe ; Raimondo, Rosa ; Re, Federica ; Guazzi, Marco ; Belardinelli, R. ; Parati, Gianfranco ; Magrì, Damiano ; Fiorentini, Cesare ; Cicoira, Mariantonietta ; Salvioni, Elisabetta ; Giovannardi, Marta ; Veglia, Fabrizio ; Mezzani, Alessandro ; Scrutinio, Domenico ; Di Lenarda, Andrea ; Ricci, Roberto ; Apostolo, Anna ; Iorio, Anna Maria ; Paolillo, Stefania ; Palermo, Pietro ; Contini, Mauro Camillo ; Vassanelli, Corrado ; Passino, Claudio ; Giannuzzi, Pantaleo ; Piepoli, Massimo F. / The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study. In: International Journal of Cardiology. 2016 ; Vol. 203. pp. 1067-1072.
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abstract = "Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF <40{\%} able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18{\%}) MECKI-D and 44 (13{\%}) MECKI-V patients (p <0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.",
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author = "Ugo Corra' and Piergiuseppe Agostoni and Andrea Giordano and Gaia Cattadori and Elisa Battaia and {La Gioia}, Rocco and Scardovi, {Angela Beatrice} and Michele Emdin and Marco Metra and Gianfranco Sinagra and Giuseppe Limongelli and Rosa Raimondo and Federica Re and Marco Guazzi and R. Belardinelli and Gianfranco Parati and Damiano Magr{\`i} and Cesare Fiorentini and Mariantonietta Cicoira and Elisabetta Salvioni and Marta Giovannardi and Fabrizio Veglia and Alessandro Mezzani and Domenico Scrutinio and {Di Lenarda}, Andrea and Roberto Ricci and Anna Apostolo and Iorio, {Anna Maria} and Stefania Paolillo and Pietro Palermo and Contini, {Mauro Camillo} and Corrado Vassanelli and Claudio Passino and Pantaleo Giannuzzi and Piepoli, {Massimo F.}",
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TY - JOUR

T1 - The metabolic exercise test data combined with Cardiac and Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study

AU - Corra', Ugo

AU - Agostoni, Piergiuseppe

AU - Giordano, Andrea

AU - Cattadori, Gaia

AU - Battaia, Elisa

AU - La Gioia, Rocco

AU - Scardovi, Angela Beatrice

AU - Emdin, Michele

AU - Metra, Marco

AU - Sinagra, Gianfranco

AU - Limongelli, Giuseppe

AU - Raimondo, Rosa

AU - Re, Federica

AU - Guazzi, Marco

AU - Belardinelli, R.

AU - Parati, Gianfranco

AU - Magrì, Damiano

AU - Fiorentini, Cesare

AU - Cicoira, Mariantonietta

AU - Salvioni, Elisabetta

AU - Giovannardi, Marta

AU - Veglia, Fabrizio

AU - Mezzani, Alessandro

AU - Scrutinio, Domenico

AU - Di Lenarda, Andrea

AU - Ricci, Roberto

AU - Apostolo, Anna

AU - Iorio, Anna Maria

AU - Paolillo, Stefania

AU - Palermo, Pietro

AU - Contini, Mauro Camillo

AU - Vassanelli, Corrado

AU - Passino, Claudio

AU - Giannuzzi, Pantaleo

AU - Piepoli, Massimo F.

PY - 2016/1/15

Y1 - 2016/1/15

N2 - Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF <40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p <0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.

AB - Background The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is a prognostic model to identify heart failure (HF) patients at risk for cardiovascular mortality (CVM) and urgent heart transplantation (uHT) based on 6 routine clinical parameters: hemoglobin, sodium, kidney function by the Modification of Diet in Renal Disease (MDRD) equation, left ventricle ejection fraction (LVEF), percentage of predicted peak oxygen consumption (VO2) and VE/VCO2 slope. Objectives MECKI score must be generalizable to be considered useful: therefore, its performance was validated in a new sequence of HF patients. Methods Both the development (MECKI-D) and the validation (MECKI-V) cohorts were composed of consecutive HF patients with LVEF <40% able to perform a symptom-limited cardiopulmonary exercise testing. The CVM or uHT rates were analyzed at one, two and three years in both cohorts: all patients with a censoring time shorter than the scheduled follow-up were excluded, while those with events occurring after 1, 2 and 3 years were considered as censored. Results MECKI-D and MECKI-V consisted of 2009 and 992 patients, respectively. MECKI-V patients had a higher LVEF, higher peak VO2 and lower VE/VCO2 slope, higher prescription of beta-blockers and device therapy: after the 3-year follow-up, CVM or uHT occurred in 206 (18%) MECKI-D and 44 (13%) MECKI-V patients (p <0.000), respectively. MECKI-V AUC values at one, two and three years were 0.81 ± 0.04, 0.76 ± 0.04, and 0.80 ± 0.03, respectively, not significantly different from MECKI-D. Conclusions MECKI score preserves its predictive ability in a HF population at a lower risk.

KW - Heart failure

KW - Prognosis, score

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U2 - 10.1016/j.ijcard.2015.11.075

DO - 10.1016/j.ijcard.2015.11.075

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JO - International Journal of Cardiology

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