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Metabolic exercise test data combined with cardiac and kidney indexes, the MECKI score: a multiparametric approach to heart failure prognosis
- Source :
- International journal of cardiology. 167(6)
- Publication Year :
- 2012
-
Abstract
- Objectives We built and validated a new heart failure (HF) prognostic model which integrates cardiopulmonary exercise test (CPET) parameters with easy-to-obtain clinical, laboratory, and echocardiographic variables. Background HF prognostication is a challenging medical judgment, constrained by a magnitude of uncertainty. Methods Our risk model was derived from a cohort of 2716 systolic HF patients followed in 13 Italian centers. Median follow up was 1041days (range 4–5185). Cox proportional hazard regression analysis with stepwise selection of variables was used, followed by cross-validation procedure. The study end-point was a composite of cardiovascular death and urgent heart transplant. Results Six variables (hemoglobin, Na + , kidney function by means of MDRD, left ventricle ejection fraction [echocardiography], peak oxygen consumption [% pred] and VE/VCO 2 slope) out of the several evaluated resulted independently related to prognosis. A score was built from Metabolic Exercise Cardiac Kidney Indexes, the MECKI score, which identified the risk of study end-point with AUC values of 0.804 (0.754–0.852) at 1year, 0.789 (0.750–0.828) at 2years, 0.762 (0.726–0.799) at 3years and 0.760 (0.724–0.796) at 4years. Conclusions This is the first large-scale multicenter study where a prognostic score, the MECKI score, has been built for systolic HF patients considering CPET data combined with clinical, laboratory and echocardiographic measurements. In the present population, the MECKI score has been successfully validated, performing very high AUC.
- Subjects :
- Male
medicine.medical_specialty
Prognosi
Population
Renal function
heart failure
Kidney Function Tests
Severity of Illness Index
Disease-Free Survival
Cohort Studies
Metabolic exercise test
Median follow-up
Internal medicine
medicine
Humans
Prospective Studies
education
Aged
Prognosis
survival score
Heart Failure
education.field_of_study
Ejection fraction
business.industry
Regression analysis
MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE
Stepwise regression
Middle Aged
medicine.disease
oxygen consumption
prognosis
Heart failure
Cohort
Heart Function Tests
Cardiology
Exercise Test
Female
Cardiology and Cardiovascular Medicine
business
Heart failure, Prognosis, Oxygen consumption
Follow-Up Studies
Subjects
Details
- ISSN :
- 18741754
- Volume :
- 167
- Issue :
- 6
- Database :
- OpenAIRE
- Journal :
- International journal of cardiology
- Accession number :
- edsair.doi.dedup.....e39cc4fbb8ac6feaf6c05db0f7cd4fa3