Cardiopulmonary exercise test (CPET) has become pivotal in the functional evaluation of patients with chronic heart failure (HF), supplying a holistic evaluation both in terms of exercise impairment degree and possible underlying mechanisms. Conversely, there is growing interest in investigating possible multiparametric approaches in order to improve the overall HF risk stratification. In such a context, in 2013, a group of 13 Italian centres skilled in HF management and CPET analysis built the Metabolic Exercise test data combined with Cardiac and Kidney Indexes (MECKI) score, based on the dynamic assessment of HF patients and on some other instrumental and laboratory parameters. Subsequently, the MECKI score, initially developed on a cohort of 2716 HF patients, has been extensively validated as well as challenged with the other multiparametric scores, achieving optimal results. Meanwhile, the MECKI score research group has grown over time, involving up to now a total of 27 centres with an available database accounting for nearly 8000 HF patients. This exciting joint effort from multiple HF Italian centres allowed to investigate different HF research field in order to deepen the mechanisms underlying HF, to improve the ability to identify patients at the highest risk as well as to analyse particular HF categories. Most recently, some of the participants of the MECKI score group started to join the forces in investigating a possible additive role of CPET assessment in the cardiomyopathy setting too. The present study tells the ten-year history of the MECKI score presenting the most important results achieved as well as those projects in the pipeline, this exciting journey being far to be concluded.

中文翻译：

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心肺运动试验对心力衰竭和心肌病患者预后评估：制作一刀切的悠久历史。

心肺运动试验（CPET）已成为慢性心力衰竭（HF）患者功能评估的关键，可提供运动损伤程度和可能的潜在机制的整体评估。相反，人们越来越有兴趣研究可能的多参数方法，以改善整体心力衰竭风险分层。在这样的背景下，2013年，意大利13个擅长心力衰竭管理和CPET分析的中心在对心力衰竭患者的动态评估和其他一些指标的基础上，建立了代谢运动测试数据与心肾指数（MECKI）评分相结合的方法。仪器和实验室参数。随后，MECKI 评分最初是在 2716 名心力衰竭患者队列中开发的，经过广泛验证并接受其他多参数评分的挑战，取得了最佳结果。与此同时，MECKI评分研究小组随着时间的推移不断发展壮大，目前已涉及27个中心，可用数据库涵盖近8000名心力衰竭患者。意大利多个心力衰竭中心的这项令人兴奋的联合努力使我们能够调查不同的心力衰竭研究领域，以深化心力衰竭的机制，提高识别最高风险患者以及分析特定心力衰竭类别的能力。最近，MECKI 评分组的一些参与者也开始联合起来研究 CPET 评估在心肌病中可能发挥的附加作用。本研究讲述了 MECKI 评分的十年历史，展示了所取得的最重要的成果以及正在酝酿中的项目，这一激动人心的旅程尚未结束。