The MECKI score demonstrated high short-term reproducibility in ambulatory HFrEF patients, with a mean difference of -0.004 and limits of agreement from -0.042 to 0.034 between tests one week apart.
Observational (n=404)
Yes
Does the MECKI score demonstrate short-term reproducibility in ambulatory patients with HFrEF?
The MECKI score demonstrates high short-term reproducibility in ambulatory HFrEF patients, supporting its reliability as a stable prognostic tool in clinical practice.
Mean Difference: -0.004 (95% CI -0.042–0.034)
Abstract Background Cardiopulmonary exercise testing (CPET) provides several prognostic parameters in patients with heart failure (HF), including peak VO2, VE/VCO2 slope, and anaerobic threshold (AT). However, the reproducibility of these variables may be affected by effort-dependence, operator variability, and methodological issues. Since the MECKI score integrates CPET with laboratory and echocardiographic parameters, understanding its short-term variability is crucial to distinguish random fluctuations from clinically meaningful changes. Aim This study aimed to assess the short-term variability of the MECKI score and its individual components in patients with heart failure with reduced ejection fraction (HFrEF), to define thresholds that separate biological variability from true clinical change. Methods We prospectively enrolled 404 HFrEF patients (LVEF 40%) across four Italian HF centers. All patients underwent two CPETs approximately one week apart, with laboratory and echocardiographic data collected at both time points. The MECKI score and its components (peak VO2, VE/VCO2 slope, hemoglobin, serum sodium, LVEF, and eGFR) were calculated for each test. Patients with conditions introducing excessive variability (e.g., dialysis) were excluded. Variability was assessed by comparing repeated measures and calculating intra-patient differences. Results The study population had a mean age of 65±12 years, 83.4% were male, and HF etiology was ischemic in 46% and non-ischemic in 47%. Medical therapy was in line with contemporary guidelines (ACEi/ARB/ARNI 96%, beta-blockers 95%, SGLT2i 83%, MRA 82%). At baseline, AT was not identifiable in 45 patients, and in 53 patients at the second test; 331 patients had AT consistently identified in both tests and were included in the main analysis. Periodic breathing was observed in 48 cases at the first and 45 at the second test. Across the study population, short-term variability of MECKI score values was low (Figure 1): mean difference (bias) was -0.004, with limits of agreement ranging from -0.042 to 0.034, indicating good agreement within the expected variability of the variable Conclusion The MECKI score shows high short-term reproducibility in ambulatory HFrEF patients. These findings reinforce the reliability of the MECKI score in clinical practice and research, supporting its use as a stable prognostic tool for heart failure patients.Figure 1For image description, please refer to the figure legend and surrounding text.
Vignati et al. (Mon,) conducted a observational in Heart failure with reduced ejection fraction (HFrEF) (n=404). MECKI score assessment was evaluated on Short-term variability of the MECKI score (mean difference -0.004, 95% CI -0.042 to 0.034). The MECKI score demonstrated high short-term reproducibility in ambulatory HFrEF patients, with a mean difference of -0.004 and limits of agreement from -0.042 to 0.034 between tests one week apart.