@article{SalzwedelHeidlerMengetal.2020, author = {Salzwedel, Annett and Heidler, Maria-Dorothea and Meng, Karin and Schikora, Martin and Wegscheider, Karl and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {Impact of cognitive performance on disease-related knowledge six months after multi-component rehabilitation in patients after an acute cardiac event}, series = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, volume = {26}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, number = {1}, publisher = {Sage Publ.}, address = {London}, issn = {2047-4873}, doi = {10.1177/2047487318791609}, pages = {46 -- 55}, year = {2020}, abstract = {Background Although associations between cardiovascular diseases and cognitive impairment are well known, the impact of cognitive performance on the success of patient education as a core component of cardiac rehabilitation remains insufficiently investigated so far. Design Prospective observational study in two inpatient cardiac rehabilitation centres between September 2014 and August 2015 with a follow-up six months after cardiac rehabilitation. Method At admission to and discharge from cardiac rehabilitation, the cognitive performance of 401 patients (54.5 ± 6.3 years, 80\% men) following an acute coronary syndrome and/or coronary artery bypass graft was tested using the Montreal Cognitive Assessment. Patients' disease-related knowledge was determined using a quiz (22 items for medical knowledge and 12 items for healthy lifestyle and behaviour) at both times and at follow-up. The change in knowledge after cardiac rehabilitation was analysed in multivariable regression models. Potentially influencing parameters (e.g. level of education, medication, cardiovascular risk factors, coronary artery bypass graft, comorbidities, exercise capacity) were considered. Results During cardiac rehabilitation, disease-related knowledge was significantly enhanced in both scales. At follow-up, the average level of medical knowledge was significantly reduced, while lifestyle knowledge remained at a stable level. The maintenance of knowledge after cardiac rehabilitation was predominantly predicted by prior knowledge, cognitive performance at discharge from cardiac rehabilitation and, in the case of medical knowledge, by coronary artery bypass graft. Conclusion Patient education in cardiac rehabilitation led to enhanced disease-related knowledge, but the maintenance of this essentially depended on patients' cognitive performance, especially after coronary artery bypass graft. Therefore, patient education concepts in cardiac rehabilitation should be reconsidered and adjusted as needed.}, language = {en} } @article{SalzwedelHeidlerHauboldetal.2017, 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}, series = {Vascular Health and Risk Management}, volume = {13}, journal = {Vascular Health and Risk Management}, publisher = {Dove Medical Press Ltd}, address = {Albany, Auckland}, issn = {1176-6344}, doi = {10.2147/VHRM.S121086}, pages = {55 -- 60}, year = {2017}, 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{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} } @article{EichlerSalzwedelReibisetal.2017, author = {Eichler, Sarah and Salzwedel, Annett and Reibis, Rona and Nothroff, J{\"o}rg and Harnath, Axel and Schikora, Martin and Butter, Christian and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {Multicomponent cardiac rehabilitation 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 = {24}, journal = {European journal of preventive cardiology : the official ESC journal for primary \& secondary cardiovascular prevention, rehabilitation and sports cardiology}, number = {3}, publisher = {Sage Publ.}, address = {London}, issn = {2047-4873}, doi = {10.1177/2047487316679527}, pages = {257 -- 264}, year = {2017}, abstract = {Background: In the last decade, transcatheter aortic valve implantation has become a promising treatment modality for patients with aortic stenosis and a high surgical risk. Little is known about influencing factors of function and quality of life during multicomponent cardiac rehabilitation. Methods: From October 2013 to July 2015, patients with elective transcatheter aortic valve implantation and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. Frailty-Index (including cognition, nutrition, autonomy and mobility), Short Form-12 (SF-12), six-minute walk distance (6MWD) and maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. The relation between patient characteristics and improvements in 6MWD, maximum work load or SF-12 scales were studied univariately and multivariately using regression models. Results: One hundred and thirty-six patients (80.6 +/- 5.0 years, 47.8\% male) were enrolled. 6MWD and maximum work load increased by 56.3 +/- 65.3 m (p < 0.001) and 8.0 +/- 14.9 watts (p < 0.001), respectively. An improvement in SF-12 (physical 2.5 +/- 8.7, p = 0.001, mental 3.4 +/- 10.2, p = 0.003) could be observed. In multivariate analysis, age and higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Higher cognition, nutrition and autonomy positively influenced the physical scale of SF-12. Additionally, the baseline values of SF-12 had an inverse impact on the change during cardiac rehabilitation. Conclusions: Cardiac rehabilitation can improve functional capacity as well as quality of life and reduce frailty in patients after transcatheter aortic valve implantation. An individually tailored therapy with special consideration of cognition and nutrition is needed to maintain autonomy and empower octogenarians in coping with challenges of everyday life.}, language = {en} } @article{KieferVoellerNothroffetal.2019, author = {Kiefer, Thomas and V{\"o}ller, Heinz and Nothroff, J{\"o}rg and Schikora, Martin and von Podewils, Sebastian and Sicher, Claudia and Bartels-Reinisch, Birgit and Heyne, Karolin and Haase, Hermann and J{\"u}nger, Michael and Daeschlein, Georg}, title = {Multiresistente Erreger in der onkologischen und kardiologischen Rehabilitation}, series = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, volume = {58}, journal = {Die Rehabilitation : Zeitschrift f{\"u}r Praxis und Forschung in der Rehabilitation}, number = {2}, publisher = {Thieme}, address = {Stuttgart}, issn = {0034-3536}, doi = {10.1055/a-0638-9226}, pages = {136 -- 142}, year = {2019}, abstract = {In der vorliegenden Studie wurde die Pr{\"a}valenz der Besiedlung mit multiresistenten Keimen an 155 Patienten aus der onkologischen und 157 Patienten aus der kardiologischen Rehabilitation mittels mikrobiologischen Screenings untersucht. Dabei zeigten 4,5\% der onkologischen und 4,5\% der kardiologischen Rehabilitationspatienten eine Besiedlung mit multiresistenten Erregern. Am h{\"a}ufigsten wurden 2-MRGN und ESBL (2,9\%) nachgewiesen. Onkologische Rehapatienten zeigten doppelt so hohe Pr{\"a}valenzraten f{\"u}r 3-MRGN im Vergleich zu kardiologischen (2,6 und 1,3\%). Insgesamt zeigen onkologische und kardiologische Rehabilitationspatienten vergleichsweise niedrige Pr{\"a}valenzraten f{\"u}r multiresistente Krankenhauskeime.}, language = {de} } @misc{KieferTrendelenburgVoellerNothroffetal.2017, author = {Kiefer-Trendelenburg, Thomas Hermann and V{\"o}ller, Heinz and Nothroff, J{\"o}rg and Schikora, Martin and Bartels-Reinisch, Birgit and Heyne, Karolin and Daeschlein, Georg}, title = {Prevalence of patients with multiresistant pathogens (MRP) in rehabilitation clinics}, series = {Oncology Research and Treatment}, volume = {40}, journal = {Oncology Research and Treatment}, publisher = {Karger}, address = {Basel}, issn = {2296-5270}, pages = {198 -- 198}, year = {2017}, 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} } @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{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} }