TY - CHAP A1 - Völler, Heinz A1 - Eichler, Sarah A1 - Harnath, Axel A1 - Kamke, Wolfram A1 - Butter, Christian A1 - Kraehe, Mathias A1 - Schikora, Martin A1 - Jachczyk, J. A1 - Salzwedel, Annett T1 - Case management in patients after TAVI: are frailty and exercise capacitiy predictors for decision making process? T2 - European heart journal Y1 - 2015 SN - 0195-668X SN - 1522-9645 VL - 36 SP - 635 EP - 635 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Kühl, Uwe A1 - Salzwedel, Annett A1 - Rasawieh, Mortesa A1 - Eichler, Sarah A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Return to work in heart failure patients with suspected viral myocarditis JF - SAGE Open Medicine N2 - 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. KW - Return to work KW - rehabilitation KW - endomyocardial biopsy KW - prediction KW - myocarditis Y1 - 2017 U6 - https://doi.org/10.1177/2050312117744978 SN - 2050-3121 VL - 5 PB - Sage CY - Thousand Oaks, Calif. ER - TY - GEN A1 - Reibis, Rona Katharina A1 - Kühl, Uwe A1 - Salzwedel, Annett A1 - Rasawieh, Mortesa A1 - Eichler, Sarah A1 - Wegscheider, Karl A1 - Völler, Heinz T1 - Return to work in heart failure patients with suspected viral myocarditis T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 378 KW - Return to work KW - rehabilitation KW - endomyocardial biopsy KW - prediction KW - myocarditis Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-407637 SN - 1866-8364 VL - 5 IS - 378 ER - TY - THES A1 - Eichler, Sarah T1 - Multidisziplinäre kardiologische Rehabilitation bei Patienten nach kathetergestützter Aortenklappenkorrektur T1 - Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation BT - Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und Lebensqualität BT - predictors of functional and psychocognitive recovery N2 - Hintergrund Für Patienten mit hochgradiger Aortenklappenstenose, die aufgrund ihres Alters oder ihrer Multimorbidität ein hohes Operationsrisiko tragen, konnte mit der kathetergestützten Aortenklappenkorrektur (transcatheter aortic valve implantation, TAVI) eine vielversprechende Alternative zum herzchirurgischen Eingriff etabliert werden. Explizite Daten zur multidisziplinären kardiologischen Rehabilitation nach TAVI liegen bislang nicht vor. Ziel vorliegender Arbeit war, den Effekt der kardiologischen Rehabilitation auf die körperliche Leistungsfähigkeit, den emotionalen Status, die Lebensqualität und die Gebrechlichkeit bei Patienten nach TAVI zu untersuchen sowie Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und der Lebensqualität zu identifizieren. Methodik Zwischen 10/2013 und 07/2015 wurden 136 Patienten (80,6 ± 5,0 Jahre, 47,8 % Männer) 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 Mobilitätsverschlechterung), die Lebensqualität im Short-Form 12 (SF-12) sowie die funktionale körperliche Leistungsfähigkeit im 6-Minuten Gehtest (6-minute walk test, 6MWT) und die maximale körperliche Leistungsfähigkeit in der Belastungs-Ergometrie erhoben. Zusätzlich wurden soziodemographische Daten (z. B. Alter und Geschlecht), Komorbiditäten (z. B. chronisch obstruktive Lungenerkrankung, koronare Herzkrankheit und Karzinom), kardiovaskuläre Risikofaktoren und die NYHA-Klasse dokumentiert. Prädiktoren für die Veränderung der körperlichen Leistungsfähigkeit und Lebensqualität wurden mit Kovarianzanalysen angepasst. Ergebnisse Die maximale Gehstrecke im 6MWT konnte um 56,3 ± 65,3 m (p < 0,001) und die maximale körperliche Leistungsfähigkeit in der Belastungs-Ergometrie um 8,0 ± 14,9 Watt (p < 0001) gesteigert werden. Weiterhin konnte eine Verbesserung im SF-12 sowohl in der körperlichen 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 höheres Alter und eine höhere Bildung signifikant mit einer geringeren Zunahme im 6MWT assoziiert, währenddessen eine bessere kognitive Leistungsfähigkeit und Adipositas einen positiven prädiktiven Wert aufwiesen. Eine höhere Selbstständigkeit und ein besserer Ernährungsstatus beeinflussten die Veränderung in der körperlichen Summenskala des SF-12 positiv, währenddessen eine bessere kognitive Leistungsfähigkeit einen Prädiktor für eine geringere Veränderung darstellte. Des Weiteren hatten die jeweiligen Ausgangswerte der körperlichen und psychischen Summenskala im SF-12 einen inversen Einfluss auf die Veränderungen in der gleichen Skala. Schlussfolgerung Eine multidisziplinäre kardiologische Rehabilitation kann sowohl die körperliche Leistungs-fähigkeit und Lebensqualität verbessern als auch die Gebrechlichkeit von Patienten nach kathetergestützter Aortenklappenkorrektur verringern. Daraus resultierend gilt es, spezifische Assessments für die kardiologische Rehabilitation zu entwickeln. Weiterhin ist es notwendig, individualisierte Therapieprogramme mit besonderem Augenmerk auf kognitive Funktionen und Ernährung zu initiieren, um die Selbstständigkeit hochbetagter Patienten zu erhalten bzw. wiederherzustellen und um die Pflegebedürftigkeit der Patienten hinauszuzögern. N2 - Background In the last decade, transcatheter aortic valve implantation (TAVI) has reached widespread clinical acceptance as treatment for elderly and high-risk patients with aortic stenosis. Little is known about influencing factors of function and quality of life during multicomponent cardi-ac rehabilitation. The aim of the underlying study was to investigate the impact of a multidis-ciplinary inpatient cardiac rehabilitation on function and frailty as well as to find predictors for changes in quality of life and physical capacity. Methods From 10/2013 to 07/2015, patients with an elective TAVI and a subsequent inpatient cardiac rehabilitation were enrolled in the prospective cohort multicentre study. A Frailty-Index (a score including Activities of Daily Living, Instrumental Activities of Daily Living, Mini Men-tal State Exam, Mini Nutritional Assessment, Timed Up and Go und subjective mobility disa-bility), quality of life by Short Form-12 (SF-12), function by 6-minute walk distance (6MWD) and by maximum work load in bicycle ergometry were performed at admission and discharge of cardiac rehabilitation. Additionally, sociodemographic parameters (e. g. age, sex), comorbidities (e. g. chronic obstructive pulmonary disease, coronary artery disease), cardiovascular risk factors and NYHA-class were documented. Predictors for changes in 6MWD and SF-12 were studied using analysis of covariance. Results 136 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 component scale 2.5 ± 8.7, p = 0.001, mental component scale 3.4 ± 10.2, p = 0.003) could be observed. In the multivariate analysis, age and a higher education were significantly associated with a reduced 6MWD, whereas cognition and obesity showed a positive predictive value. Nutrition and autonomy positively influenced the physical scale of SF-12, whereas a better cognitive performance negatively influenced it. 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 TAVI. This results in a reevaluation of diagnostic modalities, prognostic parameters and an individualised definition of achievable goals in the contemporary TAVI population during the recovery phase at cardiac rehabilitation. 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. KW - TAVI KW - Gebrechlichkeit KW - kardiologische Rehabilitation KW - Lebensqualität KW - körperliche Leistungsfähigkeit KW - TAVI KW - frailty KW - cardiac rehabilitation KW - quality of life KW - exercise capacity Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-406618 ER - TY - JOUR A1 - Salzwedel, Annett A1 - Reibis, Rona Katharina A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Buhlert, Hermann A1 - Kaminski, Stefan A1 - Völler, Heinz T1 - Cardiopulmonary exercise testing is predictive of return to work in cardiac patients after multicomponent rehabilitation JF - Clinical research in cardiology : official journal of the German Cardiac Society. N2 - 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). KW - Cardiac rehabilitation KW - Prognosis KW - Exercise capacity KW - Coronary disease KW - Social medicine Y1 - 2016 U6 - https://doi.org/10.1007/s00392-015-0917-1 SN - 1861-0684 SN - 1861-0692 VL - 105 SP - 257 EP - 267 PB - Springer CY - Heidelberg ER - TY - JOUR A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Buhlert, Hermann A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Völler, Heinz T1 - Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation JF - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology N2 - 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. KW - Cardiac rehabilitation KW - exercise tests KW - cardiorespiratory fitness KW - multivariate modelling Y1 - 2016 U6 - https://doi.org/10.1177/2047487315600815 SN - 2047-4873 SN - 2047-4881 VL - 23 SP - 452 EP - 459 PB - Sage Publ. CY - London ER - TY - GEN A1 - Völler, Heinz A1 - Eichler, Sarah A1 - Harnath, A. A1 - Nothroff, Jörg A1 - Butter, Christian A1 - Schikora, Martin A1 - Wegscheider, Karl A1 - Salzwedel, Annett T1 - Multicomponent cardiac rehabilitation in patients after transcatheter aortic valve implantation (TAVI) - course of functioning and quality of life T2 - European heart journal Y1 - 2016 SN - 0195-668X SN - 1522-9645 VL - 37 SP - 542 EP - 542 PB - Oxford Univ. Press CY - Oxford ER - TY - JOUR A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Zahn, Thomas A1 - Neuwirth, Julia A1 - Eichler, Sarah A1 - Haubold, Kathrin A1 - Wachholz, Anne A1 - Reibis, Rona Katharina A1 - Völler, Heinz T1 - User Interest in Digital Health Technologies to Encourage Physical Activity BT - Results of a Survey in Students and Staff of a German University JF - JMIR. Mhealth & Uhealth N2 - 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. KW - physical activity KW - telemedicine KW - primary prevention KW - healthy lifestyle Y1 - 2017 U6 - https://doi.org/10.2196/mhealth.7192 VL - 5 IS - 4 PB - JMIR Publications CY - Toronto ER - TY - GEN A1 - Salzwedel, Annett A1 - Rabe, Sophie A1 - Zahn, Thomas A1 - Neuwirth, Julia A1 - Eichler, Sarah A1 - Haubold, Kathrin A1 - Wachholz, Anne A1 - Reibis, Rona Katharina A1 - Völler, Heinz T1 - User Interest in Digital Health Technologies to Encourage Physical Activity BT - Results of a Survey in Students and Staff of a German University N2 - 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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 342 KW - healthy lifestyle KW - physical activity KW - primary prevention KW - telemedicine Y1 - 2017 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-401872 ER - TY - GEN A1 - Reibis, Rona Katharina A1 - Salzwedel, Annett A1 - Buhlert, Hermann A1 - Wegscheider, Karl A1 - Eichler, Sarah A1 - Völler, Heinz T1 - Impact of training methods and patient characteristics on exercise capacity in patients in cardiovascular rehabilitation T2 - Postprints der Universität Potsdam : Humanwissenschaftliche Reihe N2 - 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 Æ 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 Æ 9.7% of maximum heart rate (81% continuous/19% interval training, 64% additional strength training). A total of 12.2 Æ 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 Æ 623 watts  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. T3 - Zweitveröffentlichungen der Universität Potsdam : Humanwissenschaftliche Reihe - 442 KW - cardiac rehabilitation KW - exercise tests KW - cardiorespiratory fitness KW - multivariate modelling Y1 - 2018 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:kobv:517-opus4-405302 IS - 442 ER -