TY  - JOUR
A1  - Eichler, Sarah
A1  - Salzwedel, Annett
A1  - Harnath, Axel
A1  - Butter, Christian
A1  - Wegscheider, Karl
A1  - Chiorean, Mihai
A1  - Völler, Heinz
A1  - Reibis, Rona Katharina
T1  - Nutrition and mobility predict all-cause mortality in patients 12 months after transcatheter aortic valve implantation
JF  - Clinical research in cardiology : official journal of the German Cardiac Society.
N2  - The aim of the study was to determine pre-interventional predictors for all-cause mortality in patients after transcatheter aortic valve implantation (TAVI) with a 12-month follow-up. From 10/2013 to 07/2015, 344 patients (80.9 +/- 5.0 years, 44.5% male) with an elective TAVI were consecutively enrolled prospectively in a multicentre cohort study. Prior to the intervention, sociodemographic parameters, echocardiographic data and comorbidities were documented. All patients performed a 6-min walk test, Short Form 12 and a Frailty Index (score consisting of activities of daily living, cognition, nutrition and mobility). Peri-interventional complications were documented. Vital status was assessed over telephone 12 months after TAVI. Predictors for all-cause mortality were identified using a multivariate regression model. At discharge, 333 patients were alive (in-hospital mortality 3.2%; n = 11). During a follow-up of 381.0 +/- 41.9 days, 46 patients (13.8%) died. The non-survivors were older (82.3 +/- 5.0 vs. 80.6 +/- 5.1 years; p = 0.035), had a higher number of comorbidities (2.6 +/- 1.3 vs. 2.1 +/- 1.3; p = 0.026) and a lower left ventricular ejection fraction (51.0 +/- 13.6 vs. 54.6 +/- 10.6%; p = 0.048). Additionally, more suffered from diabetes mellitus (60.9 vs. 44.6%; p = 0.040). While the global Frailty Index had no predictive power, its individual components, particularly nutrition (OR 0.83 per 1 pt., CI 0.72-0.95; p = 0.006) and mobility (OR 5.12, CI 1.64-16.01; p = 0.005) had a prognostic impact. Likewise, diabetes mellitus (OR 2.18, CI 1.10-4.32; p = 0.026) and EuroSCORE (OR 1.21 per 5%, CI 1.07-1.36; p = 0.002) were associated with a higher risk of all-cause mortality. Besides EuroSCORE and diabetes mellitus, nutrition status and mobility of patients scheduled for TAVI offer prognostic information for 1-year all-cause mortality and should be advocated in the creation of contemporary TAVI risk scores.
KW  - TAVI
KW  - Frailty
KW  - Mortality
KW  - Malnutrition
KW  - Mobility
Y1  - 2018
U6  - https://doi.org/10.1007/s00392-017-1183-1
SN  - 1861-0684
SN  - 1861-0692
VL  - 107
IS  - 4
SP  - 304
EP  - 311
PB  - Springer
CY  - Heidelberg
ER  - 
TY  - JOUR
A1  - Vigorito, Carlo
A1  - Abreu, Ana
A1  - Ambrosetti, Marco
A1  - Belardinelli, Romualdo
A1  - Corra, Ugo
A1  - Cupples, Margaret
A1  - Davos, Constantinos H.
A1  - Hoefer, Stefan
A1  - Iliou, Marie-Christine
A1  - Schmid, Jean-Paul
A1  - Völler, Heinz
A1  - Doherty, Patrick
T1  - Frailty and cardiac rehabilitation: A call to action from the EAPC Cardiac Rehabilitation Section
JF  - European journal of preventive cardiology : the official ESC journal for primary & secondary cardiovascular prevention, rehabilitation and sports cardiology
N2  - Frailty is a geriatric syndrome characterised by a vulnerability status associated with declining function of multiple physiological systems and loss of physiological reserves. Two main models of frailty have been advanced: the phenotypic model (primary frailty) or deficits accumulation model (secondary frailty), and different instruments have been proposed and validated to measure frailty. However measured, frailty correlates to medical outcomes in the elderly, and has been shown to have prognostic value for patients in different clinical settings, such as in patients with coronary artery disease, after cardiac surgery or transvalvular aortic valve replacement, in patients with chronic heart failure or after left ventricular assist device implantation. The prevalence, clinical and prognostic relevance of frailty in a cardiac rehabilitation setting has not yet been well characterised, despite the increasing frequency of elderly patients in cardiac rehabilitation, where frailty is likely to influence the onset, type and intensity of the exercise training programme and the design of tailored rehabilitative interventions for these patients. Therefore, we need to start looking for frailty in elderly patients entering cardiac rehabilitation programmes and become more familiar with some of the tools to recognise and evaluate the severity of this condition. Furthermore, we need to better understand whether exercise-based cardiac rehabilitation may change the course and the prognosis of frailty in cardiovascular patients.
KW  - Frailty
KW  - cardiac rehabilitation
KW  - elderly
Y1  - 2017
U6  - https://doi.org/10.1177/2047487316682579
SN  - 2047-4873
SN  - 2047-4881
VL  - 24
SP  - 577
EP  - 590
PB  - Sage Publ.
CY  - London
ER  -