Rauch, Bernhard, Salzwedel, Annett ORCID: 0000-0003-2530-2673, Bjarnason-Wehrens, Birna, Albus, Christian, Meng, Karin, Schmid, Jean-Paul ORCID: 0000-0002-9008-8274, Benzer, Werner, Hackbusch, Matthes, Jensen, Katrin, Schwaab, Bernhard ORCID: 0000-0003-4801-1107, Altenberger, Johann, Benjamin, Nicola, Bestehorn, Kurt, Bongarth, Christa, Doerr, Gesine, Eichler, Sarah, Einwang, Hans-Peter, Falk, Johannes, Glatz, Johannes, Gielen, Stephan, Grilli, Maurizio ORCID: 0000-0001-7649-7242, Grunig, Ekkehard, Guha, Manju, Hermann, Matthias ORCID: 0000-0002-0694-7719, Hoberg, Eike, Hoefer, Stefan, Kaemmerer, Harald, Ladwig, Karl-Heinz, Mayer-Berger, Wolfgang, Metzendorf, Maria-Inti, Nebel, Roland ORCID: 0000-0001-6539-458X, Neidenbach, Rhoia Clara, Niebauer, Josef, Nixdorff, Uwe, Oberhoffer, Renate, Reibis, Rona, Reiss, Nils, Saure, Daniel, Schlitt, Axel, Voeler, Heinz, von Kaenel, Roland, Weinbrenner, Susanne and Westphal, Ronja (2021). Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1. J. Clin. Med., 10 (10). BASEL: MDPI. ISSN 2077-0383

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Abstract

Background: Although cardiovascular rehabilitation (CR) is well accepted in general, CR-attendance and delivery still considerably vary between the European countries. Moreover, clinical and prognostic effects of CR are not well established for a variety of cardiovascular diseases. Methods: The guidelines address all aspects of CR including indications, contents and delivery. By processing the guidelines, every step was externally supervised and moderated by independent members of the Association of the Scientific Medical Societies in Germany (AWMF). Four meta-analyses were performed to evaluate the prognostic effect of CR after acute coronary syndrome (ACS), after coronary bypass grafting (CABG), in patients with severe chronic systolic heart failure (HFrEF), and to define the effect of psychological interventions during CR. All other indications for CR-delivery were based on a predefined semi-structured literature search and recommendations were established by a formal consenting process including all medical societies involved in guideline generation. Results: Multidisciplinary CR is associated with a significant reduction in all-cause mortality in patients after ACS and after CABG, whereas HFrEF-patients (left ventricular ejection fraction <40%) especially benefit in terms of exercise capacity and health-related quality of life. Patients with other cardiovascular diseases also benefit from CR-participation, but the scientific evidence is less clear. There is increasing evidence that the beneficial effect of CR strongly depends on treatment intensity including medical supervision, treatment of cardiovascular risk factors, information and education, and a minimum of individually adapted exercise volume. Additional psychologic interventions should be performed on the basis of individual needs. Conclusions: These guidelines reinforce the substantial benefit of CR in specific clinical indications, but also describe remaining deficits in CR-delivery in clinical practice as well as in CR-science with respect to methodology and presentation.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Rauch, BernhardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Salzwedel, AnnettUNSPECIFIEDorcid.org/0000-0003-2530-2673UNSPECIFIED
Bjarnason-Wehrens, BirnaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Albus, ChristianUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Meng, KarinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schmid, Jean-PaulUNSPECIFIEDorcid.org/0000-0002-9008-8274UNSPECIFIED
Benzer, WernerUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hackbusch, MatthesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jensen, KatrinUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schwaab, BernhardUNSPECIFIEDorcid.org/0000-0003-4801-1107UNSPECIFIED
Altenberger, JohannUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Benjamin, NicolaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bestehorn, KurtUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bongarth, ChristaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Doerr, GesineUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Eichler, SarahUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Einwang, Hans-PeterUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Falk, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Glatz, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Gielen, StephanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Grilli, MaurizioUNSPECIFIEDorcid.org/0000-0001-7649-7242UNSPECIFIED
Grunig, EkkehardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Guha, ManjuUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hermann, MatthiasUNSPECIFIEDorcid.org/0000-0002-0694-7719UNSPECIFIED
Hoberg, EikeUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Hoefer, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kaemmerer, HaraldUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Ladwig, Karl-HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mayer-Berger, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Metzendorf, Maria-IntiUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nebel, RolandUNSPECIFIEDorcid.org/0000-0001-6539-458XUNSPECIFIED
Neidenbach, Rhoia ClaraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Niebauer, JosefUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nixdorff, UweUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Oberhoffer, RenateUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reibis, RonaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Reiss, NilsUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Saure, DanielUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schlitt, AxelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Voeler, HeinzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
von Kaenel, RolandUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Weinbrenner, SusanneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Westphal, RonjaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-606528
DOI: 10.3390/jcm10102192
Journal or Publication Title: J. Clin. Med.
Volume: 10
Number: 10
Date: 2021
Publisher: MDPI
Place of Publication: BASEL
ISSN: 2077-0383
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
QUALITY-OF-LIFE; CORONARY-HEART-DISEASE; AORTIC-VALVE IMPLANTATION; BYPASS GRAFT-SURGERY; PULMONARY ARTERIAL-HYPERTENSION; LUNG TRANSPLANTATION GUIDELINES; RANDOMIZED CONTROLLED-TRIAL; IMPROVES EXERCISE CAPACITY; ASSOCIATION TASK-FORCE; PHYSICAL-ACTIVITYMultiple languages
Medicine, General & InternalMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/60652

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