@article{SalzwedelReibisWegscheideretal.2016,
  author    = {Salzwedel, Annett and Reibis, Rona Katharina and Wegscheider, Karl and Eichler, Sarah and Buhlert, Hermann and Kaminski, Stefan and V{\"o}ller, Heinz},
  title     = {Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation},
  series = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  volume    = {105},
  journal   = {Clinical research in cardiology : official journal of the German Cardiac Society.},
  publisher = {Springer},
  address   = {Heidelberg},
  issn      = {1861-0684},
  doi       = {10.1007/s00392-015-0917-1},
  pages     = {257 -- 267},
  year      = {2016},
  abstract  = {Return to work (RTW) is a pivotal goal of cardiac rehabilitation (CR) in patients after acute cardiac event. We aimed to evaluate cardiopulmonary exercise testing (CPX) parameters as predictors for RTW at discharge after CR. We analyzed data from a registry of 489 working-age patients (51.5 +/- A 6.9 years, 87.9 \% men) who had undergone inpatient CR predominantly after percutaneous coronary intervention (PCI 62.6 \%), coronary artery bypass graft (CABG 17.2 \%), or heart valve replacement (9.0 \%). Sociodemographic and clinical parameters, noninvasive cardiac diagnostic (2D echo, exercise ECG, 6MWT) and psychodiagnostic screening data, as well as CPX findings, were merged with RTW data from the German statutory pension insurance program and analyzed for prognostic ability. During a mean follow-up of 26.5 +/- A 11.9 months, 373 (76.3 \%) patients returned to work, 116 (23.7 \%) did not, and 60 (12.3 \%) retired. After adjustment for covariates, elective CABG (HR 0.68, 95 \% CI 0.47-0.98; p = 0.036) and work intensity (per level HR 0.83, 95 \% CI 0.73-0.93; p = 0.002) were negatively associated with the probability of RTW. Exercise capacity in CPX (in Watts) and the VE/VCO2-slope had independent prognostic significance for RTW. A higher work load increased (HR 1.17, 95 \% CI 1.02-1.35; p = 0.028) the probability of RTW, while a higher VE/VCO2 slope decreased (HR 0.85, 95 \% CI 0.76-0.96; p = 0.009) it. CPX also had prognostic value for retirement: the likelihood of retirement decreased with increasing exercise capacity (HR 0.50, 95 \% CI 0.30-0.82; p = 0.006).},
  language  = {en}
}
@article{ReibisSalzwedelBuhlertetal.2016,
  author    = {Reibis, Rona Katharina and Salzwedel, Annett and Buhlert, Hermann and Wegscheider, Karl and Eichler, Sarah and V{\"o}ller, Heinz},
  title     = {Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {23},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  publisher = {Sage Publ.},
  address   = {London},
  issn      = {2047-4873},
  doi       = {10.1177/2047487315600815},
  pages     = {452 -- 459},
  year      = {2016},
  abstract  = {Aim We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients. Methods We studied 557 consecutive patients (51.76.9 years; 87.9\% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O-2 utilization (VO2peak) were analysed using analysis of covariance (ANCOVA) models. Results Mean training intensity was 90.7 +/- 9.7\% of maximum heart rate (81\% continuous/19\% interval training, 64\% additional strength training). A total of 12.2 +/- 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100\% was achieved (difference end/beginning of CR: 784 +/- 623 wattsxmin). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method. Conclusion CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients.},
  language  = {en}
}
@misc{ReibisSalzwedelBuhlertetal.2016,
  author    = {Reibis, Rona Katharina and Salzwedel, Annett and Buhlert, Hermann and Wegscheider, Karl and Eichler, Sarah and V{\"o}ller, Heinz},
  title     = {Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {442},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-405302},
  pages     = {8},
  year      = {2016},
  abstract  = {Aim: We aimed to identify patient characteristics and comorbidities that correlate with the initial exercise capacity of cardiac rehabilitation (CR) patients and to study the significance of patient characteristics, comorbidities and training methods for training achievements and final fitness of CR patients. Methods: We studied 557 consecutive patients (51.7 {\AE} 6.9 years; 87.9\% men) admitted to a three-week in-patient CR. Cardiopulmonary exercise testing (CPX) was performed at discharge. Exercise capacity (watts) at entry, gain in training volume and final physical fitness (assessed by peak O 2 utilization (VO 2peak ) were analysed using analysis of covariance (ANCOVA) models. Results: Mean training intensity was 90.7 {\AE} 9.7\% of maximum heart rate (81\% continuous/19\% interval training, 64\% additional strength training). A total of 12.2 {\AE} 2.6 bicycle exercise training sessions were performed. Increase of training volume by an average of more than 100\% was achieved (difference end/beginning of CR: 784 {\AE} 623 watts {\^A} min). In the multivariate model the gain in training volume was significantly associated with smoking, age and exercise capacity at entry of CR. The physical fitness level achieved at discharge from CR as assessed by VO 2peak was mainly dependent on age, but also on various factors related to training, namely exercise capacity at entry, increase of training volume and training method. Conclusion: CR patients were trained in line with current guidelines with moderate-to-high intensity and reached a considerable increase of their training volume. The physical fitness level achieved at discharge from CR depended on various factors associated with training, which supports the recommendation that CR should be offered to all cardiac patients.},
  language  = {en}
}
@misc{VoellerEichlerHarnathetal.2016,
  author    = {V{\"o}ller, Heinz and Eichler, Sarah and Harnath, A. and Nothroff, J{\"o}rg and Butter, Christian and Schikora, Martin and Wegscheider, Karl and Salzwedel, Annett},
  title     = {Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation (TAVI) - course of functioning and quality of life},
  series = {European heart journal},
  volume    = {37},
  journal   = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {542 -- 542},
  year      = {2016},
  language  = {en}
}
@misc{SalzwedelHeidlerHauboldetal.2016,
  author    = {Salzwedel, Annett and Heidler, Maria-Dorothea and Haubold, Kathrin and Schikora, Martin and Reibis, Rona Katharina and Wegscheider, Karl and J{\"o}bgens, Michael and V{\"o}ller, Heinz},
  title     = {Prevalence of mild cognitive impairment in employable patients after acute coronary event in cardiac rehabilitation},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-104113},
  pages     = {55 -- 60},
  year      = {2016},
  abstract  = {Introduction: Adequate cognitive function in patients is a prerequisite for successful implementation of patient education and lifestyle coping in comprehensive cardiac rehabilitation (CR) programs. Although the association between cardiovascular diseases and cognitive impairments (CIs) is well known, the prevalence particularly of mild CI in CR and the characteristics of affected patients have been insufficiently investigated so far. Methods: In this prospective observational study, 496 patients (54.5 ± 6.2 years, 79.8\% men) with coronary artery disease following an acute coronary event (ACE) were analyzed. Patients were enrolled within 14 days of discharge from the hospital in a 3-week inpatient CR program. Patients were tested for CI using the Montreal Cognitive Assessment (MoCA) upon admission to and discharge from CR. Additionally, sociodemographic, clinical, and physiological variables were documented. The data were analyzed descriptively and in a multivariate stepwise backward elimination regression model with respect to CI. Results: At admission to CR, the CI (MoCA score < 26) was determined in 182 patients (36.7\%). Significant differences between CI and no CI groups were identified, and CI group was associated with high prevalence of smoking (65.9 vs 56.7\%, P = 0.046), heavy (physically demanding) workloads (26.4 vs 17.8\%, P < 0.001), sick leave longer than 1 month prior to CR (28.6 vs 18.5\%, P = 0.026), reduced exercise capacity (102.5 vs 118.8 W, P = 0.006), and a shorter 6-min walking distance (401.7 vs 421.3 m, P = 0.021) compared to no CI group. The age- and education-adjusted model showed positive associations with CI only for sick leave more than 1 month prior to ACE (odds ratio [OR] 1.673, 95\% confidence interval 1.07-2.79; P = 0.03) and heavy workloads (OR 2.18, 95\% confidence interval 1.42-3.36; P < 0.01). Conclusion: The prevalence of CI in CR was considerably high, affecting more than one-third of cardiac patients. Besides age and education level, CI was associated with heavy workloads and a longer sick leave before ACE.},
  language  = {en}
}
@misc{VoellerHeidlerRiecketal.2016,
  author    = {V{\"o}ller, Heinz and Heidler, Maria-Dorothea and Rieck, Angelika and Schikora, Martin and Haubold, Kathrin and Joebges, Michael and Salzwedel, Annett},
  title     = {Prevalence of mild cognitive impairment in patients after an acute coronary syndrome in cardiac rehabilitation},
  series = {European heart journal},
  volume    = {37},
  journal   = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {543 -- 543},
  year      = {2016},
  language  = {en}
}
@article{MarxPhilipsBassengeetal.2016,
  author    = {Marx, R. and Philips, H. and Bassenge, D. and Nosper, M. and Roehrig, B. and Linck-Eleftheriadis, S. and Strandt, G. and Salzwedel, Annett and Pabst, F.},
  title     = {Progress of Rehabilitation for Cardiac Patients Depending on the Degree of Self-Sufficiency at Admission},
  series = {Die Rehabilitation : Zeitschrift f{\~A}¼r Praxis und Forschung in der Rehabilitation},
  volume    = {55},
  journal   = {Die Rehabilitation : Zeitschrift f{\~A}¼r Praxis und Forschung in der Rehabilitation},
  publisher = {Thieme},
  address   = {Stuttgart},
  issn      = {0034-3536},
  doi       = {10.1055/s-0041-111524},
  pages     = {34 -- 39},
  year      = {2016},
  abstract  = {Zusammenfassung Ziel der Studie: Es existieren kaum Publikationen uber das Rehabilitationsergebnis kardiologischer Patienten unter Berucksichtigung eines erhohten medizinischen, pflegerischen und therapeutischen Versorgungsaufwands (Barthel-Index70). Es war Ziel der Studie, die in einem Zeitraum von 2 Jahren aufgenommen Rehabilitanden (n=387) einer gesetzlichen Krankenkasse, aufgeteilt in jeweils eine Gruppe selbstversorgender und versorgungsaufwandiger Patienten, bezuglich ihrer Unterschiede in dem Rehabilitationsergebnis zu uberprufen. Methodik: In Abhangigkeit des Versorgungsaufwandes wurde das Rehabilitationsergebnis sowie Unterschiede im Verlauf hinsichtlich der korperlichen Leistungsfahigkeit, des emotionalen Status und der Aktivitaten des taglichen Lebens, gemessen an Barthelindex, FIM-Index, HADS-Werten, Komplikationen, Funktionsuntersuchungen, Belastungstests, Rehabilitationsdauer und Entlassungsform, gepruft. Ergebnisse: Die in Hinblick auf medizinischen, pflegerischen und therapeutischen Aufwand versorgungsaufwandigen Patienten waren alter, langer im Krankenhaus und in der Rehabilitation, sie hatten mehr Komplikationen und deutlich mehr Begleiterkrankungen. Sie wurden haufiger ins Akutkrankenhaus verlegt. Sie hatten eine hohere Steigerungsrate der Selbstversorgungsindices und eine relevante Steigerung bei den Belastungstests. Schlussfolgerung: Ein hoher Versorgungsaufwand multimorbider kardiologischer Patienten ist keine Kontraindikation gegen eine Rehabilitation, da auch bei dieser Patientengruppe die tragerspezifischen Rehabilitationsziele erreicht wurden. Abstract Introduction: There are hardly any publications about the outcome of cardiac rehabilitation considering patients with an increased need for medical, nursing and therapeutic care. The aim of this study, which consecutively included n=387 statutory health insurance inpatients over a period of 2 years, was to find out differences in outcome in self-care patients (Barthel index>70) as compared to patients with a need for complex care (Barthel index70). Methods: Rehabilitation outcomes concerning physical capacity, emotional status and activities of daily living as measured by Barthel index, FIM index, HADS, clinical complications, exercise test, duration of rehabilitation and form of dismission were analyzed and compared between both groups. Results: The inpatients with a Barthel index 70 at admission were older, had a longer stay in hospital and in rehabilitation, developed more complications and more often suffered from concomitant diseases. They were readmitted to hospital more often. They showed a comparatively higher increase in indices of self-care and a significant increase in physical performance tests. Conclusion: Higher medical care expenses of multimorbid cardiac inpatients are no contraindication against rehabilitation, because even in this group the specific rehabilitation aims of the healthcare payers can be reached.},
  language  = {de}
}
@misc{ReibisKuehlSalzwedeletal.2016,
  author    = {Reibis, R. and Kuehl, U. and Salzwedel, Annett and Rasawieh, M. and Wegschweider, K. and V{\"o}ller, Heinz},
  title     = {Return to work after endomyocardial biopsy in patients with suspected viral myocarditis},
  series = {European heart journal},
  volume    = {37},
  journal   = {European heart journal},
  publisher = {Oxford Univ. Press},
  address   = {Oxford},
  issn      = {0195-668X},
  pages     = {728 -- 728},
  year      = {2016},
  language  = {en}
}
@misc{RauchDavosDohertyetal.2016,
  author    = {Rauch, Bernhard and Davos, Constantinos H. and Doherty, Patrick and Saure, Daniel and Metzendorf, Maria-Inti and Salzwedel, Annett and V{\"o}ller, Heinz and Jensen, Katrin and Schmid, Jean-Paul},
  title     = {The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy},
  series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  journal   = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe},
  number    = {418},
  url       = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-405346},
  pages     = {26},
  year      = {2016},
  abstract  = {Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95\% CI 0.49-0.84; odds ratio 0.20, 95\% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95\% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation.},
  language  = {en}
}
@misc{RauchDavosDohertyetal.2016,
  author    = {Rauch, Bernhard and Davos, Constantinos H. and Doherty, Patrick and Saure, Daniel and Metzendorf, Maria-Inti and Salzwedel, Annett and V{\"o}ller, Heinz and Jensen, Katrin and Schmid, Jean-Paul},
  title     = {The prognostic effect of cardiac rehabilitation in the era of acute revascularisation and statin therapy: A systematic review and meta-analysis of randomized and non-randomized studies - The Cardiac Rehabilitation Outcome Study (CROS)},
  series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  volume    = {23},
  journal   = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology},
  publisher = {Sage Publ.},
  address   = {London},
  organization    = {Univ Heidelberg; Heinrich-Heine Univ},
  issn      = {2047-4873},
  doi       = {10.1177/2047487316671181},
  pages     = {1914 -- 1939},
  year      = {2016},
  abstract  = {Background The prognostic effect of multi-component cardiac rehabilitation (CR) in the modern era of statins and acute revascularisation remains controversial. Focusing on actual clinical practice, the aim was to evaluate the effect of CR on total mortality and other clinical endpoints after an acute coronary event. Design Structured review and meta-analysis. Methods Randomised controlled trials (RCTs), retrospective controlled cohort studies (rCCSs) and prospective controlled cohort studies (pCCSs) evaluating patients after acute coronary syndrome (ACS), coronary artery bypass grafting (CABG) or mixed populations with coronary artery disease (CAD) were included, provided the index event was in 1995 or later. Results Out of n=18,534 abstracts, 25 studies were identified for final evaluation (RCT: n=1; pCCS: n=7; rCCS: n=17), including n=219,702 patients (after ACS: n=46,338; after CABG: n=14,583; mixed populations: n=158,781; mean follow-up: 40 months). Heterogeneity in design, biometrical assessment of results and potential confounders was evident. CCSs evaluating ACS patients showed a significantly reduced mortality for CR participants (pCCS: hazard ratio (HR) 0.37, 95\% confidence interval (CI) 0.20-0.69; rCCS: HR 0.64, 95\% CI 0.49-0.84; odds ratio 0.20, 95\% CI 0.08-0.48), but the single RCT fulfilling Cardiac Rehabilitation Outcome Study (CROS) inclusion criteria showed neutral results. CR participation was also associated with reduced mortality after CABG (rCCS: HR 0.62, 95\% CI 0.54-0.70) and in mixed CAD populations. Conclusions CR participation after ACS and CABG is associated with reduced mortality even in the modern era of CAD treatment. However, the heterogeneity of study designs and CR programmes highlights the need for defining internationally accepted standards in CR delivery and scientific evaluation.},
  language  = {en}
}