Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 1
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 guid...
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| Veröffentlicht in: | Journal of clinical medicine 2021-05, Vol.10 (10), p.2192 |
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| creator | Rauch, Bernhard Salzwedel, Annett Bjarnason-Wehrens, Birna Albus, Christian Meng, Karin Schmid, Jean-Paul Benzer, Werner Hackbusch, Matthes Jensen, Katrin Schwaab, Bernhard Altenberger, Johann Benjamin, Nicola Bestehorn, Kurt Bongarth, Christa Dörr, Gesine Eichler, Sarah Einwang, Hans-Peter Falk, Johannes Glatz, Johannes Gielen, Stephan Grilli, Maurizio Grünig, Ekkehard Guha, Manju Hermann, Matthias Hoberg, Eike Höfer, Stefan Kaemmerer, Harald Ladwig, Karl-Heinz Mayer-Berger, Wolfgang Metzendorf, Maria-Inti Nebel, Roland Neidenbach, Rhoia Niebauer, Josef Nixdorff, Uwe Oberhoffer, Renate Reibis, Rona Reiss, Nils Saure, Daniel Schlitt, Axel Völler, Heinz von Känel, Roland Weinbrenner, Susanne Westphal, Ronja |
| description | 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 |
| doi_str_mv | 10.3390/jcm10102192 |
| format | Article |
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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.</description><identifier>ISSN: 2077-0383</identifier><identifier>EISSN: 2077-0383</identifier><identifier>DOI: 10.3390/jcm10102192</identifier><identifier>PMID: 34069561</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Acute coronary syndromes ; Angina pectoris ; Cardiology ; Cardiovascular disease ; Classification ; Clinical medicine ; Coronary vessels ; Decision making ; Disease prevention ; German language ; Heart failure ; Meta-analysis ; Mortality ; Patients ; Quality of life ; Rehabilitation ; Review ; Supervision ; Working groups</subject><ispartof>Journal of clinical medicine, 2021-05, Vol.10 (10), p.2192</ispartof><rights>2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). 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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.</description><subject>Acute coronary syndromes</subject><subject>Angina pectoris</subject><subject>Cardiology</subject><subject>Cardiovascular disease</subject><subject>Classification</subject><subject>Clinical medicine</subject><subject>Coronary vessels</subject><subject>Decision making</subject><subject>Disease prevention</subject><subject>German language</subject><subject>Heart failure</subject><subject>Meta-analysis</subject><subject>Mortality</subject><subject>Patients</subject><subject>Quality of life</subject><subject>Rehabilitation</subject><subject>Review</subject><subject>Supervision</subject><subject>Working 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Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of clinical medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Rauch, Bernhard</au><au>Salzwedel, Annett</au><au>Bjarnason-Wehrens, Birna</au><au>Albus, Christian</au><au>Meng, Karin</au><au>Schmid, Jean-Paul</au><au>Benzer, Werner</au><au>Hackbusch, Matthes</au><au>Jensen, Katrin</au><au>Schwaab, Bernhard</au><au>Altenberger, Johann</au><au>Benjamin, Nicola</au><au>Bestehorn, Kurt</au><au>Bongarth, Christa</au><au>Dörr, Gesine</au><au>Eichler, Sarah</au><au>Einwang, Hans-Peter</au><au>Falk, Johannes</au><au>Glatz, Johannes</au><au>Gielen, Stephan</au><au>Grilli, Maurizio</au><au>Grünig, Ekkehard</au><au>Guha, Manju</au><au>Hermann, Matthias</au><au>Hoberg, Eike</au><au>Höfer, Stefan</au><au>Kaemmerer, Harald</au><au>Ladwig, Karl-Heinz</au><au>Mayer-Berger, Wolfgang</au><au>Metzendorf, Maria-Inti</au><au>Nebel, Roland</au><au>Neidenbach, Rhoia</au><au>Niebauer, Josef</au><au>Nixdorff, Uwe</au><au>Oberhoffer, Renate</au><au>Reibis, Rona</au><au>Reiss, Nils</au><au>Saure, Daniel</au><au>Schlitt, Axel</au><au>Völler, Heinz</au><au>von Känel, Roland</au><au>Weinbrenner, Susanne</au><au>Westphal, Ronja</au><aucorp>on behalf of the Cardiac Rehabilitation Guideline Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 1</atitle><jtitle>Journal of clinical medicine</jtitle><date>2021-05-19</date><risdate>2021</risdate><volume>10</volume><issue>10</issue><spage>2192</spage><pages>2192-</pages><issn>2077-0383</issn><eissn>2077-0383</eissn><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.</abstract><cop>Basel</cop><pub>MDPI AG</pub><pmid>34069561</pmid><doi>10.3390/jcm10102192</doi><orcidid>https://orcid.org/0000-0002-0694-7719</orcidid><orcidid>https://orcid.org/0000-0003-2391-8466</orcidid><orcidid>https://orcid.org/0000-0003-2530-2673</orcidid><orcidid>https://orcid.org/0000-0001-7649-7242</orcidid><orcidid>https://orcid.org/0000-0002-9008-8274</orcidid><orcidid>https://orcid.org/0000-0002-2811-9041</orcidid><orcidid>https://orcid.org/0000-0002-8929-5129</orcidid><orcidid>https://orcid.org/0000-0001-6689-4922</orcidid><orcidid>https://orcid.org/0000-0003-4801-1107</orcidid><orcidid>https://orcid.org/0000-0002-6128-3687</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2077-0383 |
| ispartof | Journal of clinical medicine, 2021-05, Vol.10 (10), p.2192 |
| issn | 2077-0383 2077-0383 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8161282 |
| source | MDPI - Multidisciplinary Digital Publishing Institute; EZB Free E-Journals; PubMed Central; PubMed Central Open Access |
| subjects | Acute coronary syndromes Angina pectoris Cardiology Cardiovascular disease Classification Clinical medicine Coronary vessels Decision making Disease prevention German language Heart failure Meta-analysis Mortality Patients Quality of life Rehabilitation Review Supervision Working groups |
| title | Cardiac Rehabilitation in German Speaking Countries of Europe—Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH—Part 1 |
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