TY - JOUR A1 - Schwaab, Bernhard A1 - Rauch, Bernhard A1 - Völler, Heinz A1 - Benzer, Werner A1 - Schmid, Jean-Paul T1 - Beyond randomised studies BT - recommendations for cardiac rehabilitation following repair of thoracic aortic aneurysm or dissection JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology Y1 - 2020 U6 - https://doi.org/10.1177/2047487320936782 SN - 2047-4873 SN - 2047-4881 VL - 28 IS - 17 SP - E17 EP - E19 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Völler, Heinz A1 - Schwaab, Bernhard T1 - Kardiologische Rehabilitation JF - Der Kardiologe : die Fortbildungszeitschrift der Deutschen Gesellschaft für Kardiologie, Herz- und Kreislaufforschung N2 - Hintergrund Eine Verlängerung der Lebens- und Arbeitszeit erfordert einen aktiven Lebensstil, eine Optimierung von kardiovaskulären Risikofaktoren und psychosoziale Unterstützung chronisch Herzkranker. Fragestellung Können die Prognose und Lebensqualität sowie die soziale oder berufliche Teilhabe kardiovaskulär Erkrankter durch kardiologische Rehabilitation (KardReha) verbessert werden? Material und Methode Auf der Grundlage neuer Metaanalysen und aktueller Positionspapiere gibt die S3-Leitlinie zur kardiologischen Rehabilitation evidenzbasierte Empfehlungen. Ergebnisse Eine KardReha reduziert bei Patienten nach akutem Koronarsyndrom, nach PCI („percutaneous coronary interventions“) oder nach aortokoronarer Koronarbypassoperation (ACB-Op.) sowie nach Klappenkorrektur die Gesamtsterblichkeit. Bei Patienten mit systolischer Herzinsuffizienz (HFrEF [„heart failure with reduced ejection fraction“]) werden Belastbarkeit und Lebensqualität durch eine KardReha verbessert. Psychosozialer Distress kann verringert und die berufliche Wiedereingliederung besser strukturiert werden. Schlussfolgerung Im Jahr 2019 liegen aktuelle, evidenzbasierte Leitlinien vor, die aufgrund verbesserter Prognose, Belastbarkeit und Lebensqualität eine multimodale kardiologische Rehabilitation bei Patienten nach akutem kardialem Ereignis auch bei technischem Fortschritt (z. B. katheterbasierter Klappenkorrektur) und unter Aspekten der sozialen und beruflichen Teilhabe empfehlen. N2 - Background Prolonging the life span and working life requires an active lifestyle, optimization of cardiovascular risk factors and psychosocial support for patients suffering from chronic heart disease. Objective Is it possible to improve the prognosis and quality of life as well as social and occupational participation of patients with cardiovascular diseases by cardiac rehabilitation? Material and methods The S3 guidelines on cardiac rehabilitation in German-speaking countries provide evidence-based recommendations based on recent meta-analyses and current position papers. Results Cardiac rehabilitation is able to reduce overall mortality in patients with acute coronary syndrome, after percutaneous coronary interventions or surgical revascularization as well as after heart valve correction. In patients with systolic heart failure (heart failure with reduced ejection fraction, HFrEF) exercise capacity and quality of life are improved by cardiac rehabilitation. Psychosocial distress can be reduced and occupational reintegration can be adequately planned. Conclusion In 2019 current evidence-based guidelines are available that recommend a multimodal cardiac rehabilitation in patients after an acute cardiac event, due to improvement of prognosis, exercise capacity and quality of life as well as due to technical progress (e.g. catheter-based valve correction) and with respect to social and professional participation. T2 - Cardiac rehabilitation KW - Koronare Herzerkrankung KW - Herzinsuffizienz KW - Herzklappenkorrektur KW - Psychosozialer Distress KW - Lebensqualität KW - Coronary artery disease KW - Heart failure KW - Heart valve correction KW - Psychosocial distress KW - Quality of life Y1 - 2020 U6 - https://doi.org/10.1007/s12181-020-00384-2 SN - 1864-9718 SN - 1864-9726 VL - 14 IS - 2 SP - 106 EP - 112 PB - Springer CY - Berlin ER - TY - GEN A1 - Skobel, Erik A1 - Kamke, Wolfram A1 - Bönner, Gerd A1 - Alt, Bernd A1 - Purucker, Hans-Christian A1 - Schwaab, Bernhard A1 - Einwang, Hans-Peter A1 - Schröder, Klaus A1 - Langheim, Eike A1 - Völler, Heinz A1 - Brandenburg, Alexandra A1 - Graml, Andrea A1 - Woehrle, Holger A1 - Krüger, Stefan T1 - Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany BT - the Reha-Sleep registry T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Aim To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany. Methods 1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS). Results Clinically significant sleep apnoea (AHI 15/h) was documented in 33% of patients. Mean AHI was 1416/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI 15-29/h) and severe in 15% (AHI 30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001). Conclusions The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 400 KW - cardiac rehabilitation KW - sleep apnoea KW - sleep-disordered breathing Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-404814 IS - 400 ER - TY - JOUR A1 - Skobel, Erik A1 - Kamke, Wolfram A1 - Bönner, Gerd A1 - Alt, Bernd A1 - Purucker, Hans-Christian A1 - Schwaab, Bernhard A1 - Einwang, Hans-Peter A1 - Schröder, Klaus A1 - Langheim, Eike A1 - Völler, Heinz A1 - Brandenburg, Alexandra A1 - Graml, Andrea A1 - Woehrle, Holger A1 - Krüger, Stefan T1 - Risk factors for, and prevalence of, sleep apnoea in cardiac rehabilitation facilities in Germany: The Reha-Sleep registry JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Aim To determine the prevalence of, and the risk factors for, sleep apnoea in cardiac rehabilitation (CR) facilities in Germany. Methods 1152 patients presenting for CR were screened for sleep-disordered breathing with 2-channel polygraphy (ApneaLink; ResMed). Parameters recorded included the apnoea-hypopnoea index (AHI), number of desaturations per hour of recording (ODI), mean and minimum nocturnal oxygen saturation and number of snoring episodes. Patients rated subjective sleep quality on a scale from 1 (poor) to 10 (best) and completed the Epworth Sleepiness Scale (ESS). Results Clinically significant sleep apnoea (AHI 15/h) was documented in 33% of patients. Mean AHI was 1416/h (range 0-106/h). Sleep apnoea was defined as being of moderate severity in 18% of patients (AHI 15-29/h) and severe in 15% (AHI 30/h). There were small, but statistically significant, differences in ESS score and subjective sleep quality between patients with and without sleep apnoea. Logistic regression model analysis identified the following as risk factors for sleep apnoea in CR patients: age (per 10 years) (odds ratio (OR) 1.51; p<0.001), body mass index (per 5 units) (OR 1.31; p=0.001), male gender (OR 2.19; p<0.001), type 2 diabetes mellitus (OR 1.45; p=0.040), haemoglobin level (OR 0.91; p=0.012) and witnessed apnoeas (OR 1.99; p<0.001). Conclusions The findings of this study indicate that more than one-third of patients undergoing cardiac rehabilitation in Germany have sleep apnoea, with one-third having moderate-to-severe SDB that requires further evaluation or intervention. Inclusion of sleep apnoea screening as part of cardiac rehabilitation appears to be appropriate. KW - Cardiac rehabilitation KW - sleep apnoea KW - sleep-disordered breathing Y1 - 2015 U6 - https://doi.org/10.1177/2047487314537916 SN - 2047-4873 SN - 2047-4881 VL - 22 IS - 7 SP - 820 EP - 830 PB - Sage Publ. CY - London ER -