43509
2017
eng
10
882
postprint
1
--
--
--
Improvement of left ventricular ejection fraction in revascularized postmyocardial patients
BACKGROUND: Reduced left ventricular ejection fraction (LVEF) ≤30% is the most powerful prognostic indicator for sudden cardiac death (SCD) in patients after myocardial infarction (MI), but there are little data about long-term changes of LVEF after revascularization and the following implantation of a cardioverter defibrillator (ICD).
METHODS: We performed a retrospective analysis of 277 patients with reduced LVEF at least 1month after MI and complete revascularization. Patients (median time post-MI 23.4months; 74.3% after PCI, 25.7% after CABG were assigned either to group 1 (LVEF<30%) or group 2 (LVEF 30-40%). Biplane echocardiography was redone after a mean follow-up of 441±220days.
RESULTS: LVEF increased significantly in both two groups (group 1: 26.2±4.8% to 32.4±8.5%; p<0.001; group 2: 38.2±2.5% to 44.4±9.6%; p<0.001). However, statistical analysis of first and second LVEF measurement by means of a LOWESS regression and with an appropriate correction of the regression towards the mean effect revealed only a moderate increase of the mean LVEF from 35 to 37% (p<0.001) with a large interindividual variation.
CONCLUSIONS: The impact of early revascularization on LVEF appears to be low in the majority of post-MI heart failure patients. Owing to the high variability, a single measurement may not be reliable enough to justify a decision on ICD indication.
Postprints der Universität Potsdam : Mathematisch Naturwissenschaftliche Reihe
indication for statistical fallacy
10.25932/publishup-43509
urn:nbn:de:kobv:517-opus4-435093
1866-8372
BMC Research Notes 10 (2017) 244 DOI: 10.1186/s13104-017-2562-4
244
CC-BY - Namensnennung 4.0 International
Rona Katharina Reibis
Annett Salzwedel
Klaus Bonaventura
Heinz Völler
Karl Wegscheider
Zweitveröffentlichungen der Universität Potsdam : Mathematisch-Naturwissenschaftliche Reihe
882
eng
uncontrolled
cardioverter-defibrillator
eng
uncontrolled
heart failure
eng
uncontrolled
myocardial infarction
eng
uncontrolled
regression toward the mean
Biowissenschaften; Biologie
Medizin und Gesundheit
open_access
Mathematisch-Naturwissenschaftliche Fakultät
Referiert
Open Access
Universität Potsdam
https://publishup.uni-potsdam.de/files/43509/pmnr882.pdf
56698
2022
2022
eng
10
801
postprint
1
2022-11-16
2022-11-16
--
Stress management in pre-and postoperative care amongst practitioners and patients in cardiac catheterization laboratory: a study protocol
Background: As the number of cardiac diseases continuously increases within the last years in modern society, so does cardiac treatment, especially cardiac catheterization. The procedure of a cardiac catheterization is challenging for both patients and practitioners. Several potential stressors of psychological or physical nature can occur during the procedure. The objective of the study is to develop and implement a stress management intervention for both practitioners and patients that aims to reduce the psychological and physical strain of a cardiac catheterization.
Methods: The clinical study (DRKS00026624) includes two randomized controlled intervention trials with parallel groups, for patients with elective cardiac catheterization and practitioners at the catheterization lab, in two clinic sites of the Ernst-von-Bergmann clinic network in Brandenburg, Germany. Both groups received different interventions for stress management. The intervention for patients comprises a psychoeducational video with different stress management technics and additional a standardized medical information about the cardiac catheterization examination. The control condition includes the in hospitals practiced medical patient education before the examination (usual care). Primary and secondary outcomes are measured by physiological parameters and validated questionnaires, the day before (M1) and after (M2) the cardiac catheterization and at a postal follow-up 6 months later (M3). It is expected that people with standardized information and psychoeducation show reduced complications during cardiac catheterization procedures, better pre- and post-operative wellbeing, regeneration, mood and lower stress levels over time. The intervention for practitioners includes a Mindfulness-based stress reduction program (MBSR) over 8 weeks supervised by an experienced MBSR practitioner directly at the clinic site and an operative guideline. It is expected that practitioners with intervention show improved perceived and chronic stress, occupational health, physical and mental function, higher effort-reward balance, regeneration and quality of life. Primary and secondary outcomes are measured by physiological parameters (heart rate variability, saliva cortisol) and validated questionnaires and will be assessed before (M1) and after (M2) the MBSR intervention and at a postal follow-up 6 months later (M3). Physiological biomarkers in practitioners will be assessed before (M1) and after intervention (M2) on two work days and a two days off. Intervention effects in both groups (practitioners and patients) will be evaluated separately using multivariate variance analysis.
Discussion: This study evaluates the effectiveness of two stress management intervention programs for patients and practitioners within cardiac catheter laboratory. Study will disclose strains during a cardiac catheterization affecting both patients and practitioners. For practitioners it may contribute to improved working conditions and occupational safety, preservation of earning capacity, avoidance of participation restrictions and loss of performance. In both groups less anxiety, stress and complications before and during the procedures can be expected. The study may add knowledge how to eliminate stressful exposures and to contribute to more (psychological) security, less output losses and exhaustion during work. The evolved stress management guidelines, training manuals and the standardized patient education should be transferred into clinical routines
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
10.25932/publishup-56698
urn:nbn:de:kobv:517-opus4-566980
1866-8364
Block, Andrea
Version of record
<a href="http://publishup.uni-potsdam.de/56697">Bibliographieeintrag der Originalveröffentlichung/Quelle</a>
CC-BY - Namensnennung 4.0 International
Andrea Block
Klaus Bonaventura
Patricia Grahn
Felix Bestgen
Pia-Maria Wippert
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
801
eng
uncontrolled
stress management
eng
uncontrolled
mindfulness-based stress reduction
eng
uncontrolled
psychoeducation
eng
uncontrolled
standardized patient information
eng
uncontrolled
stress intervention
eng
uncontrolled
distress
eng
uncontrolled
study protocol
eng
uncontrolled
cardiac catheterization (CC)
Medizin und Gesundheit
open_access
Strukturbereich Kognitionswissenschaften
Referiert
Green Open-Access
Universität Potsdam
https://publishup.uni-potsdam.de/files/56698/phr_801.pdf
54950
2021
2022
eng
1
11
11
postprint
Universitätsverlag Potsdam
Potsdam
1
2022-05-10
2022-05-10
--
Mobile diagnostics and consultation for the prevention of the metabolic syndrome and its secondary diseases in Brandenburg—study protocol of a regional prospective cohort study: the Mobile Brandenburg Cohort
Background
The metabolic syndrome (MetS) is a risk cluster for a number of secondary diseases. The implementation of prevention programs requires early detection of individuals at risk. However, access to health care providers is limited in structurally weak regions. Brandenburg, a rural federal state in Germany, has an especially high MetS prevalence and disease burden. This study aims to validate and test the feasibility of a setup for mobile diagnostics of MetS and its secondary diseases, to evaluate the MetS prevalence and its association with moderating factors in Brandenburg and to identify new ways of early prevention, while establishing a “Mobile Brandenburg Cohort” to reveal new causes and risk factors for MetS.
Methods
In a pilot study, setups for mobile diagnostics of MetS and secondary diseases will be developed and validated. A van will be equipped as an examination room using point-of-care blood analyzers and by mobilizing standard methods. In study part A, these mobile diagnostic units will be placed at different locations in Brandenburg to locally recruit 5000 participants aged 40-70 years. They will be examined for MetS and advice on nutrition and physical activity will be provided. Questionnaires will be used to evaluate sociodemographics, stress perception, and physical activity. In study part B, participants with MetS, but without known secondary diseases, will receive a detailed mobile medical examination, including MetS diagnostics, medical history, clinical examinations, and instrumental diagnostics for internal, cardiovascular, musculoskeletal, and cognitive disorders. Participants will receive advice on nutrition and an exercise program will be demonstrated on site. People unable to participate in these mobile examinations will be interviewed by telephone. If necessary, participants will be referred to general practitioners for further diagnosis.
Discussion
The mobile diagnostics approach enables early detection of individuals at risk, and their targeted referral to local health care providers. Evaluation of the MetS prevalence, its relation to risk-increasing factors, and the “Mobile Brandenburg Cohort” create a unique database for further longitudinal studies on the implementation of home-based prevention programs to reduce mortality, especially in rural regions.
Trial registration
German Clinical Trials Register, DRKS00022764; registered 07 October 2020—retrospectively registered.
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
10.25932/publishup-54950
urn:nbn:de:kobv:517-opus4-549506
1866-8364
Version of record
Schraplau, Anne
<a href="http://publishup.uni-potsdam.de/opus4-ubp/frontdoor/index/index/docId/54951">Bibliographieeintrag der Originalveröffentlichung/Quelle</a>
CC-BY - Namensnennung 4.0 International
Anne Schraplau
Andrea Block
Andreas Häusler
Pia-Maria Wippert
Michael Armin Rapp
Heinz Völler
Klaus Bonaventura
Frank Mayer
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
759
eng
uncontrolled
Metabolic syndrome
eng
uncontrolled
Mobile diagnostics
eng
uncontrolled
Prevention
eng
uncontrolled
Nutrition
eng
uncontrolled
Physical activity
eng
uncontrolled
Rural health
Medizin und Gesundheit
open_access
Referiert
Department Sport- und Gesundheitswissenschaften
Green Open-Access
Universität Potsdam
https://publishup.uni-potsdam.de/files/54950/phr759.pdf
43010
2013
2019
eng
11
551
postprint
1
2019-06-14
2019-06-14
--
Cost-effectiveness of cardiovascular magnetic resonance and single-photon emission computed tomography for diagnosis of coronary artery disease in Germany
Background: Recent studies have demonstrated a superior diagnostic accuracy of cardiovascular magnetic resonance (CMR) for the detection of coronary artery disease (CAD). We aimed to determine the comparative cost-effectiveness of CMR versus single-photon emission computed tomography (SPECT).
Methods: Based on Bayes' theorem, a mathematical model was developed to compare the cost-effectiveness and utility of CMR with SPECT in patients with suspected CAD. Invasive coronary angiography served as the standard of reference. Effectiveness was defined as the accurate detection of CAD, and utility as the number of quality-adjusted life-years (QALYs) gained. Model input parameters were derived from the literature, and the cost analysis was conducted from a German health care payer's perspective. Extensive sensitivity analyses were performed.
Results: Reimbursement fees represented only a minor fraction of the total costs incurred by a diagnostic strategy. Increases in the prevalence of CAD were generally associated with improved cost-effectiveness and decreased costs per utility unit (Delta QALY). By comparison, CMR was consistently more cost-effective than SPECT, and showed lower costs per QALY gained. Given a CAD prevalence of 0.50, CMR was associated with total costs of (sic)6,120 for one patient correctly diagnosed as having CAD and with (sic)2,246 per Delta QALY gained versus (sic)7,065 and (sic)2,931 for SPECT, respectively. Above a threshold value of CAD prevalence of 0.60, proceeding directly to invasive angiography was the most cost-effective approach.
Conclusions: In patients with low to intermediate CAD probabilities, CMR is more cost-effective than SPECT. Moreover, lower costs per utility unit indicate a superior clinical utility of CMR.
Postprints der Universität Potsdam Humanwissenschaftliche Reihe
10.25932/publishup-43010
urn:nbn:de:kobv:517-opus4-430107
1866-8364
online registration
Journal of Cardiovascular Magnetic Resonance 15 (2013) 30 DOI: 10.1186/1532-429X-15-30
<a href="http://publishup.uni-potsdam.de/opus4-ubp/frontdoor/index/index/docId/35084">Bibliographieeintrag der Originalveröffentlichung/Quelle</a>
CC-BY - Namensnennung 4.0 International
Julia Boldt
Alexander W. Leber
Klaus Bonaventura
Christian Sohns
Martin Stula
Alexander Huppertz
Wilhelm Haverkamp
Marc Dorenkamp
Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe
551
eng
uncontrolled
cost-effectiveness
eng
uncontrolled
cardiovascular magnetic resonance
eng
uncontrolled
scintigraphy
eng
uncontrolled
coronary angiography
eng
uncontrolled
coronary artery disease
Medizin und Gesundheit
open_access
Referiert
Open Access
Department Sport- und Gesundheitswissenschaften
Institut für Sportmedizin und Prävention
Universität Potsdam
https://publishup.uni-potsdam.de/files/43010/phr551.pdf