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 cardiovascular mortality in patients with chronic heart failure with a history of reduced ejection fraction. It was developed using data obtained from an initial multicenter study based on over 2,700 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, to date, includes more than 10,000 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.

To avoid unnecessary alarm, patients who wish to use the online test are advised to do so together with their physician, whether the general practitioner or treating cardiologist, who can correctly interpret the results and their implications for treatment.

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.

The MECKI Score was designed primarily for healthcare professionals, particularly cardiologists working

Mecki Score Research’s Centers

Centro Cardiologico Monzino IRCCS, Milano (MI) Prof. Piergiuseppe Agostoni

IRCCS Maugeri, Veruno (NO) Dr. Massimo Pistono

Ospedale Santo Spirito, Roma (RM) Dott.ssa Angela Scardovi

IRCCS Maugeri, Bari (BA) Dott. Andrea Passantino

Fondazione Toscana “Gabriele Monasterio”, Pisa (PI) Prof. Michele Emdin

ASST Spedali Civili, Brescia (BS) Dott. Riccardo Maria Inciardi

ASST Spedali Civili, Brescia (BS) Prof.ssa Savina Nodari

Ospedale Vincenzo Monaldi, Napoli (NA) Prof. Giuseppe Limongelli

Università degli Studi di Napoli “Federico II”, Napoli (NA) Prof. Pasquale Perrone Filardi

Azienda sanitaria universitaria Giuliano Isontina ASUGI, Trieste (TS) Prof. Gianfranco Sinagra

IRCCS Ospedale San Raffaele, Milano (MI) Dott.ssa Rosa Raimondo

Azienda Ospedaliero Universitaria Sant’Andrea, Roma (RM) Dott. Damiano Magrì

IRCS Policlinico San Donato, San Donato Milanese (MI) Prof. Massimo Piepoli

Azienda Ospedaliero Universitaria delle Marche, Ancona (AN) Dr.ssa Maria Vittoria Matassini

IRCCS Istituto Auxologico Italiano, Ospedale San Luca, Milano (MI) Prof. Gianfranco Parati

IRCCS ISMETT, Palermo (PA) Dott. Manlio Cipriani

Azienda Ospedaliero Universitaria “Policlinico Foggia”, Foggia (FG) Dott. Michele Correale

ASST Grande Ospedale Metropolitano Niguarda, Milano (MI) Dott. Enrico Perna

IRCCS Maugeri, Milano (MI) Dott. Maurizio Bussotti

Azienda Ospedaliero Universitaria Policlinico Umberto I, Roma (RM) Dott. Domenico Filomena

IRCCS MultiMedica, Ospedale San Giuseppe, Milano (MI) Dott.ssa Gaia Cattadori

IRCCS MultiMedica, Sesto San Giovanni (MI) Dott. Francesco Bandera

ASST Papa Giovanni XXIII, Bergamo (BG) Dott.ssa Annamaria Iorio

Azienda sanitaria universitaria Giuliano Isontina ASUGI, Trieste (TS) Dott. Andrea Di Lenarda

Università degli Studi di Napoli “Federico II”, Napoli (NA) Prof. Antonio Cittadini

Ospedale Guglielmo da Saliceto, Piacenza (PC) Dott. Francesco Di Spigno

Ospedale Santa Maria alle Scotte, Siena (SI) Dott. Alberto Palazzuoli

Ospedale Santa Maria alle Scotte, Siena (SI) Dott.ssa Francesca Righini

Ospedale San Paolo, Milano (MI) Prof. Marco Guazzi

Ospedale Madonna del Soccorso, San Benedetto del Tronto (AP) Dott.ssa Sara Sfredda

Ospedale Vito Fazzi, Lecce (LE) Dott. Mario Donateo

Ospedale di Rivoli, Rivoli (TO) Dott. Alessandro Galluzzo

Ospedale di Mondovì, Mondovì (CN) Dott. Fabio Anastasio

Ospedale Bellaria, Bologna (BO) Dott.ssa Maria Grazia Poci

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