Almost one million people in Italy suffer from heart failure. There are different forms, of varying severity, which can have a different impact on heart function and quality of life. And it is important to be able to assess, on a case-by-case basis, the characteristics of the patient, the burden of other diseases that may be present, the cardiac response capacity. In short, you need something that really measures the severity and dangers associated with this condition. This question is now answered by the Italian research through the MECKI (Metabolic Exercise Cardiac Kidney Index) score.
Heart failure, patient management changes
This is a heart failure risk index developed by the Monzino Cardiology Center thanks to the collaboration of 27 heart failure units present throughout the country. The MECKI calculation is based on cardiopulmonary test values combined with other echocardiographic and laboratory parameters: hemoglobin, sodium, renal function, left ventricular ejection fraction, peak oxygen consumption and ventilatory efficiency under strain. There are six different parameters that together establish the severity of the patient in the most objective way possible. The calculator is also available online, can be found online and is also available in an iPad version, which can be downloaded for free from iTunes.
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The MECKI score enters the clinical practice of all cardiologists in Europe following the official introduction in the guidelines of the European Society of Cardiology (ESC). The score makes it possible to assess the individual mortality risk of the decompensated patient and consequently to identify the subjects who most need treatment. “MECKI score is one of Monzino’s major contributions to cardiology – he points out Piergiuseppe Agostoni, director of the Department of Critical and Rehabilitative Cardiology and full professor of cardiovascular diseases at the University of Milan – my group and I conceived it to respond to the need of family doctors and cardiologists to be able to count on an effective scientific method to identify the prognosis of patients with chronic heart failure.
It is a sophisticated but simple algorithm that, by combining patient-specific parameters, calculates the combined risk of death from cardiovascular causes or the need for an urgent heart transplant or left ventricular assist implant. The study that made it possible to realize the algorithm, published on International Journal of Cardiology in 2012, it collected data from over 7500 patients, with an average follow-up of over 4 years “.
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But be careful: don’t make the mistake of self-assessing. This system, although available, must always be interpreted by the doctor. “The test is designed for the clinical support of treating physicians – recalls Agostoni – it is anonymous and theoretically accessible to all, but in order not to generate alarmism we strongly recommend that patients who still want to use it perform the test online always together with their doctor. in fact, it is difficult for a patient to have the required values available, and above all only a doctor is able to correctly interpret the result and the related effects on therapies. “
In any case, for an effective approach to heart failure, it is important to remember the importance of the correct diagnosis and then implement specific therapies. There air hunger it is a sign that should not be underestimated, even if it often occurs when cardiac fatigue is already advanced. Otherwise the most common symptoms are the appearance of swelling in the feet and legs, a profound sense of fatigue with lack of energy, theorthopnea, that is a breathing difficulty that is alleviated by assuming the sitting position, theswollen abdomen. Over time it can also lead to pulmonary edema: the sufferer struggles to breathe because the lungs fill with fluid.
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