Metabolic Exercise Test Data Combined with Cardiac and Kidney Indexes (MECKI) Score Evolution: Identification of Cardiovascular Risk in Patients with Heart Failure

Summary

Heart failure is a complex condition involving multiple organs beyond the cardiovascular system, all influencing disease progression and prognosis. Accurate risk assessment requires considering multiple variables, as no single parameter alone provides a complete prognostic picture.

This has led to the development of prognostic models combining clinical and laboratory parameters. Some of these models incorporate cardiopulmonary exercise testing (CPET), which provides key prognostic indicators. Since the 1990s, CPET has been recommended in heart failure management guidelines due to its strong prognostic value when combined with clinical data.

However, existing risk models often exclude important predictors such as ventilatory parameters from CPET (VE/VCO₂), renal function, and hemoglobin levels. To address this gap, in 2012 the investigators developed the MECKI (Metabolic Exercise test data combined with Cardiac and Kidney Indexes) score, integrating oxygen consumption, ventilatory efficiency, and easily accessible biochemical and echocardiographic parameters. Unlike previous models requiring extensive data collection, MECKI is based on only six variables, making it practical and effective.

Recent studies suggest the need to update the cutoff values and parameters used for risk stratification, as new therapies and treatment strategies may significantly alter prognostic accuracy in different patient populations.

This study aims to expand and refine the MECKI score by updating the patient dataset, optimizing its performance in specific subgroups, and aligning it with emerging therapeutic approaches.

Additionally, the investigators will evaluate whether the model's risk accuracy varies in advanced-stage patients, those with comorbidities, or under different treatment regimens. This could lead to correction factors that enhance the score's predictive power across diverse clinical scenarios, further improving its applicability and reliability in heart failure management.

Conditions

• Heart Failure

Sponsors & Collaborators

• Santo Spirito Hospital, Italy

  collaborator OTHER

• Fondazione Toscana Gabriele Monasterio

  collaborator OTHER

• Spedali Civili, University of Brescia, Italy

  collaborator UNKNOWN

• Monaldi Hospital

  collaborator OTHER

• Azienda Sanitaria Universitaria Giuliano Isontina (ASU GI)

  collaborator UNKNOWN

• San Raffaele University Hospital, Italy

  collaborator OTHER

• University of Foggia

  collaborator OTHER

• Azienda Ospedaliera Niguarda Cà Granda

  collaborator OTHER

• Azienda Policlinico Umberto I

  collaborator OTHER

• Federico II University of Naples, Department of Clinical Medicine and Surgery, Naples, Italy

  collaborator UNKNOWN

• Città di Lecce Hospital

  collaborator UNKNOWN

• Policlinico G . Martino, Messina Italy

  collaborator UNKNOWN

• Azienda Ospedaliera Universitaria Senese

  collaborator OTHER

• Azienda Sanitaria di Firenze

  collaborator OTHER

• Ospedale San Luca, Istituto Auxologico Italiano, Milano

  collaborator UNKNOWN

• Casa di Cura Mater Dei

  collaborator UNKNOWN

• University of Bari

  collaborator OTHER

• Azienda Ospedaliera di Perugia

  collaborator OTHER

• I.R.C.C.S. Policlinico San Donato, San Donato Milanese, Italy

  collaborator UNKNOWN

• IRCCS Multimedica

  collaborator OTHER

• Ospedali Riuniti Ancona

  collaborator OTHER

• ASST Papa Giovanni XXIII, Bergamo, Italy

  collaborator UNKNOWN

• S. Andrea Hospital

  collaborator OTHER

• Istituti Clinici Scientifici Maugeri SpA

  collaborator OTHER

• Istituto Auxologico Italiano - IRCCS - Ospedale San Luca - Milano

  collaborator UNKNOWN

• Azienda Ospedaliero-Universitaria Senese

  collaborator UNKNOWN

• The Mediterranean Institute for Transplantation and Advanced Specialized Therapies

  collaborator OTHER

• Federico II University

  collaborator OTHER

• Ospedale Guglielmo da Saliceto, Piacenza

  collaborator UNKNOWN

• Centro Cardiologico Monzino

  lead OTHER

Eligibility

Min Age

18 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2021-02-10

Primary Completion

2026-12-31

Completion

2028-12-31

Countries

• Italy

Study Locations