@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} } @article{ReibisKuehlSalzwedeletal.2017, author = {Reibis, Rona Katharina and K{\"u}hl, Uwe and Salzwedel, Annett and Rasawieh, Mortesa and Eichler, Sarah and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {Return to work in heart failure patients with suspected viral myocarditis}, series = {SAGE Open Medicine}, volume = {5}, journal = {SAGE Open Medicine}, publisher = {Sage}, address = {Thousand Oaks, Calif.}, issn = {2050-3121}, doi = {10.1177/2050312117744978}, year = {2017}, abstract = {Background: Endomyocardial biopsy is considered as the gold standard in patients with suspected myocarditis. We aimed to evaluate the impact of bioptic findings on prediction of successful return to work. Methods: In 1153 patients (48.9 ± 12.4 years, 66.2\% male), who were hospitalized due to symptoms of left heart failure between 2005 and 2012, an endomyocardial biopsy was performed. Routine clinical and laboratory data, sociodemographic parameters, and noninvasive and invasive cardiac variables including endomyocardial biopsy were registered. Data were linked with return to work data from the German statutory pension insurance program and analyzed by Cox regression. Results: A total of 220 patients had a complete data set of hospital and insurance information. Three quarters of patients were virus-positive (54.2\% parvovirus B19, other or mixed infection 16.7\%). Mean invasive left ventricular ejection fraction was 47.1\% ± 18.6\% (left ventricular ejection fraction <45\% in 46.3\%). Return to work was achieved after a mean interval of 168.8 ± 347.7 days in 220 patients (after 6, 12, and 24 months in 61.3\%, 72.2\%, and 76.4\%). In multivariate regression analysis, only age (per 10 years, hazard ratio, 1.27; 95\% confidence interval, 1.10-1.46; p = 0.001) and left ventricular ejection fraction (per 5\% increase, hazard ratio, 1.07; 95\% confidence interval, 1.03-1.12; p = 0.002) were associated with increased, elevated work intensity (heavy vs light, congestive heart failure, 0.58; 95\% confidence interval, 0.34-0.99; p < 0.049) with decreased probability of return to work. None of the endomyocardial biopsy-derived parameters was significantly associated with return to work in the total group as well as in the subgroup of patients with biopsy-proven myocarditis. Conclusion: Added to established predictors, bioptic data demonstrated no additional impact for return to work probability. Thus, socio-medical evaluation of patients with suspected myocarditis furthermore remains an individually oriented process based primarily on clinical and functional parameters.}, language = {en} } @misc{ReibisKuehlSalzwedeletal.2018, author = {Reibis, Rona Katharina and K{\"u}hl, Uwe and Salzwedel, Annett and Rasawieh, Mortesa and Eichler, Sarah and Wegscheider, Karl and V{\"o}ller, Heinz}, title = {Return to work in heart failure patients with suspected viral myocarditis}, series = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, volume = {5}, journal = {Postprints der Universit{\"a}t Potsdam : Humanwissenschaftliche Reihe}, number = {378}, issn = {1866-8364}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-407637}, year = {2018}, abstract = {Background: Endomyocardial biopsy is considered as the gold standard in patients with suspected myocarditis. We aimed to evaluate the impact of bioptic findings on prediction of successful return to work. Methods: In 1153 patients (48.9 ± 12.4 years, 66.2\% male), who were hospitalized due to symptoms of left heart failure between 2005 and 2012, an endomyocardial biopsy was performed. Routine clinical and laboratory data, sociodemographic parameters, and noninvasive and invasive cardiac variables including endomyocardial biopsy were registered. Data were linked with return to work data from the German statutory pension insurance program and analyzed by Cox regression. Results: A total of 220 patients had a complete data set of hospital and insurance information. Three quarters of patients were virus-positive (54.2\% parvovirus B19, other or mixed infection 16.7\%). Mean invasive left ventricular ejection fraction was 47.1\% ± 18.6\% (left ventricular ejection fraction <45\% in 46.3\%). Return to work was achieved after a mean interval of 168.8 ± 347.7 days in 220 patients (after 6, 12, and 24 months in 61.3\%, 72.2\%, and 76.4\%). In multivariate regression analysis, only age (per 10 years, hazard ratio, 1.27; 95\% confidence interval, 1.10-1.46; p = 0.001) and left ventricular ejection fraction (per 5\% increase, hazard ratio, 1.07; 95\% confidence interval, 1.03-1.12; p = 0.002) were associated with increased, elevated work intensity (heavy vs light, congestive heart failure, 0.58; 95\% confidence interval, 0.34-0.99; p < 0.049) with decreased probability of return to work. None of the endomyocardial biopsy-derived parameters was significantly associated with return to work in the total group as well as in the subgroup of patients with biopsy-proven myocarditis. Conclusion: Added to established predictors, bioptic data demonstrated no additional impact for return to work probability. Thus, socio-medical evaluation of patients with suspected myocarditis furthermore remains an individually oriented process based primarily on clinical and functional parameters.}, language = {en} } @phdthesis{Eichler2017, author = {Eichler, Sarah}, title = {Multidisziplin{\"a}re kardiologische Rehabilitation bei Patienten nach kathetergest{\"u}tzter Aortenklappenkorrektur}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-406618}, school = {Universit{\"a}t Potsdam}, pages = {XI, 63, XXXI}, year = {2017}, abstract = {Hintergrund F{\"u}r Patienten mit hochgradiger Aortenklappenstenose, die aufgrund ihres Alters oder ihrer Multimorbidit{\"a}t ein hohes Operationsrisiko tragen, konnte mit der kathetergest{\"u}tzten Aortenklappenkorrektur (transcatheter aortic valve implantation, TAVI) eine vielversprechende Alternative zum herzchirurgischen Eingriff etabliert werden. Explizite Daten zur multidisziplin{\"a}ren kardiologischen Rehabilitation nach TAVI liegen bislang nicht vor. Ziel vorliegender Arbeit war, den Effekt der kardiologischen Rehabilitation auf die k{\"o}rperliche Leistungsf{\"a}higkeit, den emotionalen Status, die Lebensqualit{\"a}t und die Gebrechlichkeit bei Patienten nach TAVI zu untersuchen sowie Pr{\"a}diktoren f{\"u}r die Ver{\"a}nderung der k{\"o}rperlichen Leistungsf{\"a}higkeit und der Lebensqualit{\"a}t zu identifizieren. Methodik Zwischen 10/2013 und 07/2015 wurden 136 Patienten (80,6 ± 5,0 Jahre, 47,8 \% M{\"a}nner) in Anschlussheilbehandlung nach TAVI in drei kardiologischen Rehabilitationskliniken eingeschlossen. Zur Beurteilung des Effekts der kardiologischen Rehabilitation wurden jeweils zu Beginn und Ende der Rehabilitation der Frailty (Gebrechlichkeits)-Index (Score bestehend aus Barthel-Index, Instrumental Activities of Daily Living, Mini Mental State Exam, Mini Nutritional Assessment, Timed Up and Go und subjektiver Mobilit{\"a}tsverschlechterung), die Lebensqualit{\"a}t im Short-Form 12 (SF-12) sowie die funktionale k{\"o}rperliche Leistungsf{\"a}higkeit im 6-Minuten Gehtest (6-minute walk test, 6MWT) und die maximale k{\"o}rperliche Leistungsf{\"a}higkeit in der Belastungs-Ergometrie erhoben. Zus{\"a}tzlich wurden soziodemographische Daten (z. B. Alter und Geschlecht), Komorbidit{\"a}ten (z. B. chronisch obstruktive Lungenerkrankung, koronare Herzkrankheit und Karzinom), kardiovaskul{\"a}re Risikofaktoren und die NYHA-Klasse dokumentiert. Pr{\"a}diktoren f{\"u}r die Ver{\"a}nderung der k{\"o}rperlichen Leistungsf{\"a}higkeit und Lebensqualit{\"a}t wurden mit Kovarianzanalysen angepasst. Ergebnisse Die maximale Gehstrecke im 6MWT konnte um 56,3 ± 65,3 m (p < 0,001) und die maximale k{\"o}rperliche Leistungsf{\"a}higkeit in der Belastungs-Ergometrie um 8,0 ± 14,9 Watt (p < 0001) gesteigert werden. Weiterhin konnte eine Verbesserung im SF-12 sowohl in der k{\"o}rperlichen Summenskala um 2,5 ± 8,7 Punkte (p = 0,001) als auch in der psychischen Summenskala um 3,4 ± 10,2 Punkte (p = 0,003) erreicht werden. In der multivariaten Analyse waren ein h{\"o}heres Alter und eine h{\"o}here Bildung signifikant mit einer geringeren Zunahme im 6MWT assoziiert, w{\"a}hrenddessen eine bessere kognitive Leistungsf{\"a}higkeit und Adipositas einen positiven pr{\"a}diktiven Wert aufwiesen. Eine h{\"o}here Selbstst{\"a}ndigkeit und ein besserer Ern{\"a}hrungsstatus beeinflussten die Ver{\"a}nderung in der k{\"o}rperlichen Summenskala des SF-12 positiv, w{\"a}hrenddessen eine bessere kognitive Leistungsf{\"a}higkeit einen Pr{\"a}diktor f{\"u}r eine geringere Ver{\"a}nderung darstellte. Des Weiteren hatten die jeweiligen Ausgangswerte der k{\"o}rperlichen und psychischen Summenskala im SF-12 einen inversen Einfluss auf die Ver{\"a}nderungen in der gleichen Skala. Schlussfolgerung Eine multidisziplin{\"a}re kardiologische Rehabilitation kann sowohl die k{\"o}rperliche Leistungs-f{\"a}higkeit und Lebensqualit{\"a}t verbessern als auch die Gebrechlichkeit von Patienten nach kathetergest{\"u}tzter Aortenklappenkorrektur verringern. Daraus resultierend gilt es, spezifische Assessments f{\"u}r die kardiologische Rehabilitation zu entwickeln. Weiterhin ist es notwendig, individualisierte Therapieprogramme mit besonderem Augenmerk auf kognitive Funktionen und Ern{\"a}hrung zu initiieren, um die Selbstst{\"a}ndigkeit hochbetagter Patienten zu erhalten bzw. wiederherzustellen und um die Pflegebed{\"u}rftigkeit der Patienten hinauszuz{\"o}gern.}, language = {de} } @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{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} } @article{SalzwedelRabeZahnetal.2017, author = {Salzwedel, Annett and Rabe, Sophie and Zahn, Thomas and Neuwirth, Julia and Eichler, Sarah and Haubold, Kathrin and Wachholz, Anne and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {User Interest in Digital Health Technologies to Encourage Physical Activity}, series = {JMIR. Mhealth \& Uhealth}, volume = {5}, journal = {JMIR. Mhealth \& Uhealth}, number = {4}, publisher = {JMIR Publications}, address = {Toronto}, doi = {10.2196/mhealth.7192}, year = {2017}, abstract = {Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users. Objective: The aim of this study was the explorative, nuanced determination of the interest in mHealth apps with respect to PA among students and staff of a university. Methods: We conducted a Web-based survey from June to July 2015 in which students and employees from the University of Potsdam were asked about their activity level, interest in mHealth fitness apps, chronic diseases, and sociodemographic parameters. Results: A total of 1217 students (67.30\%, 819/1217; female; 26.0 years [SD 4.9]) and 485 employees (67.5\%, 327/485; female; 42.7 years [SD 11.7]) participated in the survey. The recommendation for PA (3 times per week) was not met by 70.1\% (340/485) of employees and 52.67\% (641/1217) of students. Within these groups, 53.2\% (341/641 students) and 44.2\% (150/340 employees)—independent of age, sex, body mass index (BMI), and level of education or professional qualification—indicated an interest in mHealth fitness apps. Conclusions: Even in a younger, highly educated population, the majority of respondents reported an insufficient level of PA. About half of them indicated their interest in training support. This suggests that the use of personalized mobile fitness apps may become increasingly significant for a positive change of lifestyle.}, language = {en} } @misc{SalzwedelRabeZahnetal.2017, author = {Salzwedel, Annett and Rabe, Sophie and Zahn, Thomas and Neuwirth, Julia and Eichler, Sarah and Haubold, Kathrin and Wachholz, Anne and Reibis, Rona Katharina and V{\"o}ller, Heinz}, title = {User Interest in Digital Health Technologies to Encourage Physical Activity}, url = {http://nbn-resolving.de/urn:nbn:de:kobv:517-opus4-401872}, pages = {8}, year = {2017}, abstract = {Background: Although the benefits for health of physical activity (PA) are well documented, the majority of the population is unable to implement present recommendations into daily routine. Mobile health (mHealth) apps could help increase the level of PA. However, this is contingent on the interest of potential users. Objective: The aim of this study was the explorative, nuanced determination of the interest in mHealth apps with respect to PA among students and staff of a university. Methods: We conducted a Web-based survey from June to July 2015 in which students and employees from the University of Potsdam were asked about their activity level, interest in mHealth fitness apps, chronic diseases, and sociodemographic parameters. Results: A total of 1217 students (67.30\%, 819/1217; female; 26.0 years [SD 4.9]) and 485 employees (67.5\%, 327/485; female; 42.7 years [SD 11.7]) participated in the survey. The recommendation for PA (3 times per week) was not met by 70.1\% (340/485) of employees and 52.67\% (641/1217) of students. Within these groups, 53.2\% (341/641 students) and 44.2\% (150/340 employees)—independent of age, sex, body mass index (BMI), and level of education or professional qualification—indicated an interest in mHealth fitness apps. Conclusions: Even in a younger, highly educated population, the majority of respondents reported an insufficient level of PA. About half of them indicated their interest in training support. This suggests that the use of personalized mobile fitness apps may become increasingly significant for a positive change of lifestyle.}, 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} }