TY - JOUR A1 - Hansen, Dominique A1 - Dendale, Paul A1 - Coninx, Karin A1 - Vanhees, Luc A1 - Piepoli, Massimo F. A1 - Niebauer, Josef A1 - Cornelissen, Veronique A1 - Pedretti, Roberto A1 - Geurts, Eva A1 - Ruiz, Gustavo R. A1 - Corra, Ugo A1 - Schmid, Jean-Paul A1 - Greco, Eugenio A1 - Davos, Constantinos H. A1 - Edelmann, Frank A1 - Abreu, Ana A1 - Rauch, Bernhard A1 - Ambrosetti, Marco A1 - Braga, Simona S. A1 - Barna, Olga A1 - Beckers, Paul A1 - Bussotti, Maurizio A1 - Fagard, Robert A1 - Faggiano, Pompilio A1 - Garcia-Porrero, Esteban A1 - Kouidi, Evangelia A1 - Lamotte, Michel A1 - Neunhaeuserer, Daniel A1 - Reibis, Rona Katharina A1 - Spruit, Martijn A. A1 - Stettler, Christoph A1 - Takken, Tim A1 - Tonoli, Cajsa A1 - Vigorito, Carlo A1 - Völler, Heinz A1 - Doherty, Patrick T1 - The European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool: A digital training and decision support system for optimized exercise prescription in cardiovascular disease. Concept, definitions and construction methodology JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - Background Exercise rehabilitation is highly recommended by current guidelines on prevention of cardiovascular disease, but its implementation is still poor. Many clinicians experience difficulties in prescribing exercise in the presence of different concomitant cardiovascular diseases and risk factors within the same patient. It was aimed to develop a digital training and decision support system for exercise prescription in cardiovascular disease patients in clinical practice: the European Association of Preventive Cardiology Exercise Prescription in Everyday Practice and Rehabilitative Training (EXPERT) tool. Methods EXPERT working group members were requested to define (a) diagnostic criteria for specific cardiovascular diseases, cardiovascular disease risk factors, and other chronic non-cardiovascular conditions, (b) primary goals of exercise intervention, (c) disease-specific prescription of exercise training (intensity, frequency, volume, type, session and programme duration), and (d) exercise training safety advices. The impact of exercise tolerance, common cardiovascular medications and adverse events during exercise testing were further taken into account for optimized exercise prescription. Results Exercise training recommendations and safety advices were formulated for 10 cardiovascular diseases, five cardiovascular disease risk factors (type 1 and 2 diabetes, obesity, hypertension, hypercholesterolaemia), and three common chronic non-cardiovascular conditions (lung and renal failure and sarcopaenia), but also accounted for baseline exercise tolerance, common cardiovascular medications and occurrence of adverse events during exercise testing. An algorithm, supported by an interactive tool, was constructed based on these data. This training and decision support system automatically provides an exercise prescription according to the variables provided. Conclusion This digital training and decision support system may contribute in overcoming barriers in exercise implementation in common cardiovascular diseases. KW - Cardiovascular disease KW - rehabilitation KW - exercise training KW - training and decision support system Y1 - 2017 U6 - https://doi.org/10.1177/2047487317702042 SN - 2047-4873 SN - 2047-4881 VL - 24 SP - 1017 EP - 1031 PB - Sage Publ. CY - London ER - TY - JOUR A1 - Hansen, Dominique A1 - Niebauer, Josef A1 - Cornelissen, Veronique A1 - Barna, Olga A1 - Neunhaeuserer, Daniel A1 - Stettler, Christoph A1 - Tonoli, Cajsa A1 - Greco, Eugenio A1 - Fagard, Robert A1 - Coninx, Karin A1 - Vanhees, Luc A1 - Piepoli, Massimo F. A1 - Pedretti, Roberto A1 - Ruiz, Gustavo Rovelo A1 - Corra, Ugo A1 - Schmid, Jean-Paul A1 - Davos, Constantinos H. A1 - Edelmann, Frank A1 - Abreu, Ana A1 - Rauch, Bernhard A1 - Ambrosetti, Marco A1 - Braga, Simona Sarzi A1 - Beckers, Paul A1 - Bussotti, Maurizio A1 - Faggiano, Pompilio A1 - Garcia-Porrero, Esteban A1 - Kouidi, Evangelia A1 - Lamotte, Michel A1 - Reibis, Rona Katharina A1 - Spruit, Martijn A. A1 - Takken, Tim A1 - Vigorito, Carlo A1 - Völler, Heinz A1 - Doherty, Patrick A1 - Dendale, Paul T1 - Exercise prescription in patients with different combinations of cardiovascular disease risk factors BT - a consensus statement from the EXPERT working group JF - Sports medicine N2 - Whereas exercise training is key in the management of patients with cardiovascular disease (CVD) risk (obesity, diabetes, dyslipidaemia, hypertension), clinicians experience difficulties in how to optimally prescribe exercise in patients with different CVD risk factors. Therefore, a consensus statement for state-of-the-art exercise prescription in patients with combinations of CVD risk factors as integrated into a digital training and decision support system (the EXercise Prescription in Everyday practice & Rehabilitative Training (EXPERT) tool) needed to be established. EXPERT working group members systematically reviewed the literature for meta-analyses, systematic reviews and/or clinical studies addressing exercise prescriptions in specific CVD risk factors and formulated exercise recommendations (exercise training intensity, frequency, volume and type, session and programme duration) and exercise safety precautions, for obesity, arterial hypertension, type 1 and 2 diabetes, and dyslipidaemia. The impact of physical fitness, CVD risk altering medications and adverse events during exercise testing was further taken into account to fine-tune this exercise prescription. An algorithm, supported by the interactive EXPERT tool, was developed by Hasselt University based on these data. Specific exercise recommendations were formulated with the aim to decrease adipose tissue mass, improve glycaemic control and blood lipid profile, and lower blood pressure. The impact of medications to improve CVD risk, adverse events during exercise testing and physical fitness was also taken into account. Simulations were made of how the EXPERT tool provides exercise prescriptions according to the variables provided. In this paper, state-of-the-art exercise prescription to patients with combinations of CVD risk factors is formulated, and it is shown how the EXPERT tool may assist clinicians. This contributes to an appropriately tailored exercise regimen for every CVD risk patient. Y1 - 2018 U6 - https://doi.org/10.1007/s40279-018-0930-4 SN - 0112-1642 SN - 1179-2035 VL - 48 IS - 8 SP - 1781 EP - 1797 PB - Springer CY - Northcote ER - TY - JOUR A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review JF - Journal of Clinical Medicine N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2021 U6 - https://doi.org/10.3390/jcm10194506 SN - 2077-0383 VL - 10 SP - 1 EP - 17 PB - MDPI CY - Basel, Schweiz ET - 19 ER - TY - GEN A1 - Baritello, Omar A1 - Salzwedel, Annett A1 - Sündermann, Simon A1 - Niebauer, Josef A1 - Völler, Heinz T1 - The Pandora's Box of frailty assessments: Which is the best for clinical purposes in TAVI patients? A critical review T2 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe N2 - Frailty assessment is recommended before elective transcatheter aortic valve implantation (TAVI) to determine post-interventional prognosis. Several studies have investigated frailty in TAVI-patients using numerous assessments; however, it remains unclear which is the most appropriate tool for clinical practice. Therefore, we evaluate which frailty assessment is mainly used and meaningful for ≤30-day and ≥1-year prognosis in TAVI patients. Randomized controlled or observational studies (prospective/retrospective) investigating all-cause mortality in older (≥70 years) TAVI patients were identified (PubMed; May 2020). In total, 79 studies investigating frailty with 49 different assessments were included. As single markers of frailty, mostly gait speed (23 studies) and serum albumin (16 studies) were used. Higher risk of 1-year mortality was predicted by slower gait speed (highest Hazard Ratios (HR): 14.71; 95% confidence interval (CI) 6.50–33.30) and lower serum albumin level (highest HR: 3.12; 95% CI 1.80–5.42). Composite indices (five items; seven studies) were associated with 30-day (highest Odds Ratio (OR): 15.30; 95% CI 2.71–86.10) and 1-year mortality (highest OR: 2.75; 95% CI 1.55–4.87). In conclusion, single markers of frailty, in particular gait speed, were widely used to predict 1-year mortality. Composite indices were appropriate, as well as a comprehensive assessment of frailty. View Full-Text T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 765 KW - frailty tool KW - TAVI KW - older patients KW - elderly KW - cardiology KW - mortality Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-550440 SN - 1866-8364 VL - 10 SP - 1 EP - 17 PB - Universitätsverlag Potsdam CY - Potsdam ET - 19 ER -