A Dynamic Evaluation of Chronic Heart Failure Prognosis: the MECKI Score

Summary

The project is dedicated to the improvement of our capability to provide a precise and personalized prognosis in heart failure (HF) patients in stable conditions. The Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score is one of the 3 HF prognostic models recommended by the 2021 European HF guidelines and it is considered the most powerful prognostic tool available. MECKI score integrates cardiopulmonary exercise test (CPET) data with easy-to-obtain clinical, laboratory, and echocardiographic variables. It is based on 6 parameters: peak oxygen intake (peakVO2), minute ventilation/carbon dioxide production (VE/VCO2 slope), hemoglobin (Hb), Left Ventricle Ejection Fraction (LVEF), kidney function by Modification of Diet in Renal Disease (MDRD) formula, and sodium (Na+). The aim of the present project is to assess the day-by-day MECKI score variability, CPET parameters interobserver variability, characterization of HF patients who change MECKI score values in 6 and 12 months, and the prognostic meaning of time dependent MECKI score changes.

Eligibility

Inclusion Criteria:

* Previous or present HF symptoms (NYHA functional class I-IV, stage B and C of ACC/AHA classification)
* history or presence of left ventricular ejection fraction (LVEF)\<40%
* unchanged HF medications for at least three months
* ability to perform a CPET
* no major cardiovascular treatment or intervention scheduled

Exclusion Criteria:

* History of pulmonary embolism
* moderate-to-severe aortic and mitral stenosis
* pericardial disease
* severe obstructive lung disease
* exercise-induced angina
* significant ECG alterations, or presence of any clinical comorbidity interfering with exercise performance

Conditions2

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