MECKI Score: The Metabolic Exercise test data combined with Cardiac and Kidney Indexes

The MECKI Score is an anonymous tool for calculating the risk of chronic systolic heart failure, created using data obtained from a multicenter study based on over 2700 patients with an average follow up of more than 3 years. The tool is reserved exclusively for the clinical support of treating physicians.

The MECKI Score project is continuously evolving and the registry currently includes more than 7500 patients with an average follow up of more than 4 years. It constitutes a continuous source of data for scientific studies aimed at optimizing the study of the prognosis of patients with heart failure.

In order not to generate alarmism, it is recommended to patients who want to use it to perform the online test always with their own doctor, i.e. the general practitioner or the treating cardiologist, able to correctly interpret the result and its effects on therapies.

Centro Cardiologico Monzino is available to collaborate with the treating physician in the analysis of the MECKI Score results, by contacting the Heart Failure and Clinical Cardiology Unit at +39 02 58002010 or writing to fpcr@cardiologicomonzino.it.

Mecki Score Research’s Centers

Cardiology Center​ Monzino, IRCCS, Milano Piergiuseppe Agostoni, Valentina Mantegazza, Elisabetta Salvioni, Fabrizio Veglia, Anna Apostolo, Stefania Farina, Mauro Contini, Pietro Palermo, Cesare Fiorentini, Marta Giovannardi, Alice Bonomi, Valentina Mantegazza, Massimo Mapelli

Hospital S. Luca – Dipartimento di Cardiologia, Milano Gianfranco Parati, Gabriella Malfatto, Sergio Caravita

Hospital Niguarda Ca’Granda, IRCCS, Dipartimento Cardiologico “A. De Gasperis”, Milano Fabrizio Oliva, Maria Frigerio.

IRCCS Multimedica, Milano Gaia Cattadori, Davide Girola

Istituti Clinici Scientifici Maugeri, Veruno (NO) Ugo Corrà, Alessandro Mezzani, Pantaleo Giannuzzi

Complesso Monumentale S. Spirito in Sassia - Divisione di Cardiologia, Roma Angela Scardovi, Roberto Ricci, Alessandro Ferraironi

Azienda Ospedaliera S. Camillo, Divisione Cardiologia, Roma Federica Re

Azienda Ospedaliera S. Andrea, Dipartimento di Medicina Clinica e Molecolare, Roma Damiano Magrì

Roma Sapienza Roberto Badagliacca, Susanna Sciomer

Istituti Clinici Scientifici Maugeri, Divisione di Cardiologia, Cassano delle Murge (BA) Rocco La Gioia, Domenico Scrutinio, Andrea Passantino

Scuola Superiore di Sant’Anna, Fondazione Gabriele Monasterio, CNR-Regione Toscana, Pisa Michele Emdin, Luigi Pastormerlo, Claudio Passino

Ospedali Civili, Dipartimento di specialità Mediche e Chirurgiche, Scienze Radiologiche e Salute Pubblica, Brescia Marco Metra, Livio Dei Cas, Valentina Carubelli, Carlo Lombardi

Ospedali Monaldi (Azienda dei Colli), Cardiologia SUN, Seconda Università di Napoli Giuseppe Limongelli, Giuseppe Pacileo, Daniele Masarone

Università Federico II, Dipartimento di Scienze Biomediche Avanzate, Napoli Stefania Paolillo, Paola Gargiulo, Pasquale Perrone Filardi

Ospedali Riuniti, Dipartimento Cardiovascolare, Trieste Gianfranco Sinagra, Elena Zambon, Marco Confalonieri, Marco Morosin

Azienda per i Servizi Sanitari n°1, Centro Cardiovascolare, Trieste Andrea Di Lenarda, Chiara Torregiani

Divisione di Cardiologia Riabilitativa , Istituti Clinici Scientifici Maugeri, Tradate (VA) Rosa Raimondo, Raffaella Vaninetti

Ospedale S. Paolo, S. Donato, IRCCS, San Donato (MI) Marco Guazzi

Ospedali Riuniti, Lancisi (AN) Romualdo Belardinelli

Università di Verona, Sezione di Cardiologia, Dipartimento di Medicina Mariantonietta Cicoira

ISMETT (Istituto Mediterraneo per I Trapianti e Terapie ad Alta Specializzazione), Palermo Chiara Minà, Francesco Clemenza

Ospedale Guglielmo da Saliceto, Piacenza Massimo Piepoli, Simone Binno

​Università di Foggia, Dipartimento di Cardiologia Michele Correale

Department of Cardiology, S. Chiara Hospital, Trento Elisa Battaia

List of Publications

1. Agostoni P., Emdin M., Corrà U., et al., Permanent atrial fibrillation affects exercise capacity in chronic heart failure patients. Eur Heart J, 2008. 29(19): p. 2367-72. https://doi.org/10.1093/eurheartj/ehn361

2. Agostoni P., Corrà U., Cattadori G., et al., Prognostic value of indeterminable anaerobic threshold in heart failure. Circ Heart Fail, 2013. 6(5): p. 977-87. https://doi.org/10.1161/CIRCHEARTFAILURE.113.000471

3. Agostoni P., Corrà U., Cattadori G., et al., Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score: a multiparametric approach to heart failure prognosis. Int J Cardiol, 2013. 167(6): p. 2710-8. DOI: 10.1016/j.ijcard.2012.06.113

4. Cattadori G., Agostoni P., Corrà U., et al., Severe heart failure prognosis evaluation for transplant selection in the era of beta-blockers: role of peak oxygen consumption. Int J Cardiol, 2013. 168(5): p. 5078-81. DOI: 10.1016/j.ijcard.2013.07.192

5. Carubelli V., Metra M., Corrà U., et al., Exercise Performance Is a Prognostic Indicator in Elderly Patients With Chronic Heart Failure--Application of Metabolic Exercise Cardiac Kidney Indexes Score. Circ J, 2015. 79(12): p. 2608-15. DOI: 10.1253/circj.CJ-15-0026

6. Corrà U., Agostoni P., Piepoli M.F., Metabolic exercise data combined with cardiac and kidney indexes: MECKI score. Predictive role in cardiopulmonary exercise testing with low respiratory exchange ratio in heart failure. Int J Cardiol, 2015. 184: p. 299-301. doi: 10.1016/j.ijcard.2015.02.070

7. Magrì D., Agostoni P., Corrà U., et al., Deceptive meaning of oxygen uptake measured at the anaerobic threshold in patients with systolic heart failure and atrial fibrillation. Eur J Prev Cardiol, 2015. 22(8): p. 1046-55. doi: 10.1177/2047487314551546

8. Paolillo S., Agostoni P., Masarone D., et al., Prognostic role of atrial fibrillation in patients affected by chronic heart failure. Data from the MECKI score research group. Eur J Intern Med, 2015. 26(7): p. 515-20. DOI: 10.1016/j.ejim.2015.04.023

9. Scrutinio D., Agostoni P., Gesualdo L., et al., Renal function and peak exercise oxygen consumption in chronic heart failure with reduced left ventricular ejection fraction. Circ J, 2015. 79(3): p. 583-91. https://doi.org/10.1253/circj.CJ-14-0806

10. Corra U., Agostoni P., Giordano A., et al., The metabolic exercise test data combined with Cardiac And Kidney Indexes (MECKI) score and prognosis in heart failure. A validation study. Int J Cardiol, 2016. 203: p. 1067-72. DOI: 10.1016/j.ijcard.2015.11.075

11. Corra U., Agostoni P., Giordano A., et al., Sex Profile and Risk Assessment With Cardiopulmonary Exercise Testing in Heart Failure: Propensity Score Matching for Sex Selection Bias. Can J Cardiol, 2016. 32(6): p. 754-9. doi: 10.1016/j.cjca.2015.09.010

12. Piepoli M.F., Corrà U., Veglia F., et al., Exercise tolerance can explain the obesity paradox in patients with systolic heart failure: data from the MECKI Score Research Group. Eur J Heart Fail, 2016. 18(5): p. 545-53. doi: 10.1002/ejhf.534

13. Agostoni P., Paolillo S., Mapelli M., et al., Multiparametric prognostic scores in chronic heart failure with reduced ejection fraction: a long-term comparison. Eur J Heart Fail, 2017. https://doi.org/10.1002/ejhf.989

14. Cattadori G., Agostoni P., Corrà U., et al., Heart failure and anemia: Effects on prognostic variables. Eur J Intern Med, 2017. 37: p. 56-63.doi:10.1016/j.ejim.2016.09.011

15. Paolillo S., Mapelli M., Bonomi A., et al., Prognostic role of beta-blocker selectivity and dosage regimens in heart failure patients. Insights from the MECKI score database. Eur J Heart Fail, 2017. 19(7): p. 904-914. doi: 10.1002/ejhf.775

16. Bruno N., Sinagra G., Paolillo S., et al., Mineralocorticoid receptor antagonists for heart failure: a real-life observational study. ESC Heart Fail, 2018. doi: 10.1002/ehf2.12244

17. Campodonico J., Piepoli M., Clemenza F., et al., Dose-dependent efficacy of beta-blocker in patients with chronic heart failure and atrial fibrillation. Int J Cardiol, 2018. 273: p. 141-146. doi: 10.1016/j.ijcard.2018.08.012

18. Carriere C., Corrà U., Piepoli M., et al., Anaerobic Threshold and Respiratory Compensation Point Identification During Cardiopulmonary Exercise Tests in Chronic Heart Failure. Chest, 2019. 156(2): p. 338-347. doi: 10.1016/j.chest.2019.03.013

19. Carriere C., Corrà U., Piepoli M., et al., Isocapnic buffering period: From physiology to clinics. Eur J Prev Cardiol, 2019. 26(10): p. 1107-1114. doi: 10.1177/2047487319829950

20. Paolillo S., Veglia F., Salvioni E., et al., Heart failure prognosis over time: how the prognostic role of oxygen consumption and ventilatory efficiency during exercise has changed in the last 20 years. Eur J Heart Fail, 2019. doi: 10.1002/ejhf.1364

21. Piepoli M.F., Salvioni E., Corrà U., et al., Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group. Eur J Intern Med, 2019. doi: 10.1016/j.ejim.2019.11.003

22. Rovai S., Corrà U., Piepoli M., et al., Exercise oscillatory ventilation and prognosis in heart failure patients with reduced and mid-range ejection fraction. Eur J Heart Fail, 2019. 21(12): p. 1586-1595. https://doi.org/10.1002/ejhf.1595

23. Magrì D., Piepoli M., Corrà U., et al., Cardiovascular Death Risk in Recovered Mid-Range Ejection Fraction Heart Failure: Insights from Cardiopulmonary Exercise Test. J Card Fail, 2020. doi: 10.1016/j.cardfail.2020.04.021

24. Paolillo S., Salvioni E., Perrone Filardi P., et al., Long-term prognostic role of diabetes mellitus and glycemic control in heart failure patients with reduced ejection fraction: Insights from the MECKI Score database. Int J Cardiol, 2020. doi: 10.1016/j.ijcard.2020.04.079

25. Piepoli M.F., Salvioni E., Corrà U., et al., Increased serum uric acid level predicts poor prognosis in mildly severe chronic heart failure with reduced ejection fraction. An analysis from the MECKI score research group. Eur J Intern Med, 2020. 72: p. 47-52. doi: 10.1016/j.ejim.2019.11.003

26. Salvioni E., Bonomi A., Re F., et al., The MECKI score initiative: Development and state of the art. Eur J Prev Cardiol, 2020. 27(2_suppl): p. 5-11. doi: 10.1177/2047487320959010

27. Salvioni E., Corrà U., Piepoli M., et al., Gender and age normalization and ventilation efficiency during exercise in heart failure with reduced ejection fraction. ESC Heart Fail, 2020. doi: 10.1002/ehf2.12582

Special Issue

Volume 27 Issue 2_suppl: Cardiopulmonary exercise testing in clinical practice. The Mecki Score initiative Supplement, December 2020, pp. 3-75