@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} }