@article{SalzwedelRieckReibisetal.2015,
  author    = {Salzwedel, Annett and Rieck, Angelika and Reibis, Rona Katharina and V{\"o}ller, Heinz},
  title     = {Routine initial exercise stress testing for treatment stratification in comprehensive cardiac rehabilitation},
  series = {International journal of rehabilitation research},
  volume    = {38},
  journal   = {International journal of rehabilitation research},
  number    = {4},
  publisher = {Lippincott Williams \& Wilkins},
  address   = {Philadelphia},
  issn      = {0342-5282},
  doi       = {10.1097/MRR.0000000000000133},
  pages     = {344 -- 349},
  year      = {2015},
  abstract  = {There is evidence of substantial benefit of cardiac rehabilitation (CR) for patients with low exercise capacity at admission. Nevertheless, some patients are not able to perform an initial exercise stress test (EST). We aimed to describe this group using data of 1094 consecutive patients after a cardiac event (71 +/- 7 years, 78\% men) enrolled in nine centres for inpatient CR. We analysed sociodemographic and clinical variables (e.g. cardiovascular risk factors, comorbidities, complications at admission), amount of therapy (e.g. exercise training, nursing care) and the results of the initial and the final 6-min walking test (6MWT) with respect to the application of an EST. Fifteen per cent of patients did not undergo an EST (non-EST group). In multivariable analysis, the probability of obtaining an EST was higher for men [odds ratio (OR) 1.89, P=0.01], a 6MWT (per 10 m, OR 1.07, P<0.01) and lower for patients with diabetes mellitus (OR 0.48, P<0.01), NYHA-class III/IV (OR 0.27, P<0.01), osteoarthritis (OR 0.39, P<0.01) and a longer hospital stay (per 5 days, OR 0.87, P=0.02). The non-EST group received fewer therapy units of exercise training, but more units of nursing care and physiotherapy than the EST group. However, there were no significant differences between both groups in the increase of the 6MWT during CR (123 vs. 108 m, P=0.122). The present study confirms the feasibility of an EST at the start of CR as an indicator of disease severity. Nevertheless, patients without EST benefit from CR even if exercising less. Thus, there is a justified need for individualized, comprehensive and interdisciplinary CR.},
  language  = {en}
}
@article{RoehrigSalzwedelLinckEleftheriadisetal.2015,
  author    = {R{\"o}hrig, Bernd and Salzwedel, Annett and Linck-Eleftheriadis, Sigrid and V{\"o}ller, Heinz and Nosper, Manfred},
  title     = {Outcome Based Center Comparisons in Inpatient Cardiac Rehabilitation Results from the EVA-Reha (R) Cardiology Project},
  series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation},
  volume    = {54},
  journal   = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation},
  number    = {1},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0034-3536},
  doi       = {10.1055/s-0034-1395556},
  pages     = {45 -- 52},
  year      = {2015},
  abstract  = {Background: So far, for center comparisons in inpatient cardiac rehabilitation (CR), the objective outcome quality was neglected because of challenges in quantifying the overall success of CR. In this article, a multifactorial benchmark model measuring the individual rehabilitation success is presented. Methods: In 21 rehabilitation centers, 5 123 patients were consecutively enrolled between 01/2010 and 12/2012 in the prospective multicenter registry EVA-Reha (R) Cardiology. Changes in 13 indicators in the areas cardiovascular risk factors, physical performance and subjective health during rehabilitation were evaluated according to levels of severity. Changes were only rated for patients who needed a medical intervention. Additionally, the changes had to be clinically relevant. Therefore Minimal Important Differences (MID) were predefined. Ratings were combined to a single score, the multiple outcome criterion (MEK). Results: The MEK was determined for all patients (71.7 +/- 7.4 years, 76.9 \% men) and consisted of an average of 5.6 indicators. After risk adjustment for sociodemographic and clinical baseline parameters, MEK was used for center ranking. In addition, individual results of indicators were compared with means of all study sites. Conclusion: With the method presented here, the outcome quality can be quantified and outcome-based comparisons of providers can be made.},
  language  = {de}
}
@article{SalzwedelWegscheiderHerichetal.2015,
  author    = {Salzwedel, Annett and Wegscheider, Karl and Herich, Lena and Rieck, Angelika and Strandt, Gert and V{\"o}ller, Heinz},
  title     = {Impact of clinical and sociodemographic patient characteristics on the outcome of cardiac rehabilitation in older patients},
  series = {Aging clinical and experimental research},
  volume    = {27},
  journal   = {Aging clinical and experimental research},
  number    = {3},
  publisher = {Springer},
  address   = {New York},
  issn      = {1594-0667},
  doi       = {10.1007/s40520-014-0283-2},
  pages     = {315 -- 321},
  year      = {2015},
  abstract  = {Background Cardiac rehabilitation (CR) seeks to simultaneously improve several outcome parameters related to patient risk factors, exercise capacity and subjective health. A single score, the multiple outcome criterion (MOC), comprised of alterations in 13 outcome variables was used to measure the overall success of CR in an older population. As this success depends on the older patient's characteristics at the time of admission to CR, we attempted to determine the most important influences. Methods The impact of baseline characteristics on the success of CR, measured by MOC, was analysed using a mixed model for 1,220 older patients (70.9 +/- A 7.0 years, 78.3 \% men) who enrolled in 12 CR clinics. A multitude of potentially influential baseline patient characteristics was considered including sociodemographic variables, comorbidity, duration of hospital stay, exercise capacity, cardiovascular risk factors, emotional status, and laboratory and echocardiographic data. Results Overall, CR was successful, as indicated by the mean value of the MOC (0.6 +/- A 0.45; min -1.0, max 2.0; positive values denoting improvement, negative ones deterioration). Examples of association with negative MOC values included smoking (MOC -0.15, p < 0.001), female gender (MOC -0.07, p = 0.049), and a longer hospital stay (MOC -0.03, p = 0.03). An example of association with positive MOC value was depression score (MOC 0.06, p = 0.003). Further associations included maximal exercise capacity, blood pressure, heart rate and the rehabilitation centre attended. Conclusion Our results emphasize the necessity to take into consideration baseline characteristics when evaluating the success of CR and setting treatment targets for older patients.},
  language  = {en}
}
@article{VoellerSalzwedelNitardyetal.2015,
  author    = {V{\"o}ller, Heinz and Salzwedel, Annett and Nitardy, Aischa and Buhlert, Hermann and Treszl, Andras and Wegscheider, Karl},
  title     = {Effect of cardiac rehabilitation on functional and emotional status in patients after transcatheter aortic-valve implantation},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {22},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  number    = {5},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487314526072},
  pages     = {568 -- 574},
  year      = {2015},
  abstract  = {Background Transcatheter aortic-valve implantation (TAVI) is an established alternative therapy in patients with severe aortic stenosis and a high surgical risk. Despite a rapid growth in its use, very few data exist about the efficacy of cardiac rehabilitation (CR) in these patients. We assessed the hypothesis that patients after TAVI benefit from CR, compared to patients after surgical aortic-valve replacement (sAVR). Methods From September 2009 to August 2011, 442 consecutive patients after TAVI (n=76) or sAVR (n=366) were referred to a 3-week CR. Data regarding patient characteristics as well as changes of functional (6-min walk test. 6-MWT), bicycle exercise test), and emotional status (Hospital Anxiety and Depression Scale) were retrospectively evaluated and compared between groups after propensity score adjustment. Results Patients after TAVI were significantly older (p<0.001), more female (p<0.001), and had more often coronary artery disease (p=0.027), renal failure (p=0.012) and a pacemaker (p=0.032). During CR, distance in 6-MWT (both groups p0.001) and exercise capacity (sAVR p0.001, TAVI p0.05) significantly increased in both groups. Only patients after sAVR demonstrated a significant reduction in anxiety and depression (p0.001). After propensity scores adjustment, changes were not significantly different between sAVR and TAVI, with the exception of 6-MWT (p=0.004). Conclusions Patients after TAVI benefit from cardiac rehabilitation despite their older age and comorbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life.},
  language  = {en}
}
@inproceedings{VoellerEichlerHarnathetal.2015,
  author    = {V{\"o}ller, Heinz and Eichler, Sarah and Harnath, Axel and Kamke, Wolfram and Butter, Christian and Kraehe, Mathias and Schikora, Martin and Jachczyk, J. and Salzwedel, Annett},
  title     = {Case management in patients after TAVI: are frailty and exercise capacitiy predictors for decision making process?},
  series = {European heart journal},
  volume    = {36},
  booktitle = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {635 -- 635},
  year      = {2015},
  language  = {en}
}
@inproceedings{VoellerSalzwedelReibisetal.2015,
  author    = {V{\"o}ller, Heinz and Salzwedel, Annett and Reibis, Rona Katharina and Eichler, Sarah and Buhlert, Hermann and Kaminski, Stefan and Wegscheider, Karl},
  title     = {Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation},
  series = {European heart journal},
  volume    = {36},
  booktitle = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {635 -- 636},
  year      = {2015},
  language  = {en}
}