@article{SchwaabBjarnasonWehrensMengetal.2021,
  author    = {Schwaab, Bernhard and Bjarnason-Wehrens, Birna and Meng, Karin and Albus, Christian and Salzwedel, Annett and Schmid, Jean-Paul and Benzer, Werner and Metz, Matthes and Jensen, Katrin and Rauch, Bernhard and B{\"o}nner, Gerd and Brzoska, Patrick and Buhr-Schinner, Heike and Charrier, Albrecht and Cordes, Carsten and D{\"o}rr, Gesine and Eichler, Sarah and Exner, Anne-Kathrin and Fromm, Bernd and Gielen, Stephan and Glatz, Johannes and Gohlke, Helmut and Grilli, Maurizio and Gysan, Detlef and H{\"a}rtel, Ursula and Hahmann, Harry and Herrmann-Lingen, Christoph and Karger, Gabriele and Karoff, Marthin and Kiwus, Ulrich and Knoglinger, Ernst and Krusch, Christian-Wolfgang and Langheim, Eike and Mann, Johannes and Max, Regina and Metzendorf, Maria-Inti and Nebel, Roland and Niebauer, Josef and Predel, Hans-Georg and Preßler, Axel and Razum, Oliver and Reiss, Nils and Saure, Daniel and von Schacky, Clemens and Sch{\"u}tt, Morten and Schultz, Konrad and Skoda, Eva-Maria and Steube, Diethard and Streibelt, Marco and St{\"u}ttgen, Martin and St{\"u}ttgen, Michaela and Teufel, Martin and Tschanz, Hansueli and V{\"o}ller, Heinz and Vogel, Heiner and Westphal, Ronja},
  title     = {Cardiac rehabilitation in German speaking countries of Europe — evidence-based guidelines from Germany, Austria and Switzerland LLKardReha-DACH — part 2},
  series = {Journal of Clinical Medicine},
  volume    = {10},
  journal   = {Journal of Clinical Medicine},
  number    = {14},
  issn      = {2077-0383},
  doi       = {10.3390/jcm10143071},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242645},
  year      = {2021},
  abstract  = {Background: Scientific guidelines have been developed to update and harmonize exercise based cardiac rehabilitation (ebCR) in German speaking countries. Key recommendations for ebCR indications have recently been published in part 1 of this journal. The present part 2 updates the evidence with respect to contents and delivery of ebCR in clinical practice, focusing on exercise training (ET), psychological interventions (PI), patient education (PE). In addition, special patients' groups and new developments, such as telemedical (Tele) or home-based ebCR, are discussed as well. Methods: Generation of evidence and search of literature have been described in part 1. Results: Well documented evidence confirms the prognostic significance of ET in patients with coronary artery disease. Positive clinical effects of ET are described in patients with congestive heart failure, heart valve surgery or intervention, adults with congenital heart disease, and peripheral arterial disease. Specific recommendations for risk stratification and adequate exercise prescription for continuous-, interval-, and strength training are given in detail. PI when added to ebCR did not show significant positive effects in general. There was a positive trend towards reduction in depressive symptoms for "distress management" and "lifestyle changes". PE is able to increase patients' knowledge and motivation, as well as behavior changes, regarding physical activity, dietary habits, and smoking cessation. The evidence for distinct ebCR programs in special patients' groups is less clear. Studies on Tele-CR predominantly included low-risk patients. Hence, it is questionable, whether clinical results derived from studies in conventional ebCR may be transferred to Tele-CR. Conclusions: ET is the cornerstone of ebCR. Additional PI should be included, adjusted to the needs of the individual patient. PE is able to promote patients self-management, empowerment, and motivation. Diversity-sensitive structures should be established to interact with the needs of special patient groups and gender issues. Tele-CR should be further investigated as a valuable tool to implement ebCR more widely and effectively.},
  language  = {en}
}
@article{LadwigLederbogenAlbusetal.2014,
  author    = {Ladwig, Karl-Heinz and Lederbogen, Florian and Albus, Christian and Angermann, Christiane and Borggrefe, Martin and Fischer, Denise and Fritzsche, Kurt and Haass, Markus and Jordan, Jochen and J{\"u}nger, Jana and Kindermann, Ingrid and K{\"o}llner, Volker and Kuhn, Bernhard and Scherer, Martin and Seyfarth, Melchior and V{\"o}ller, Heinz and Waller, Christiane and Herrmann-Lingen, Christoph},
  title     = {Position paper on the importance of psychosocial factors in cardiology: Update 2013},
  series = {GMS German Medical Science},
  volume    = {12},
  journal   = {GMS German Medical Science},
  doi       = {10.3205/000194},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-121196},
  year      = {2014},
  abstract  = {Background: The rapid progress of psychosomatic research in cardiology and also the increasing impact of psychosocial issues in the clinical daily routine have prompted the Clinical Commission of the German Heart Society (DGK) to agree to an update of the first state of the art paper on this issue which was originally released in 2008. Methods: The circle of experts was increased, general aspects were implemented and the state of the art was updated. Particular emphasis was dedicated to coronary heart diseases (CHD), heart rhythm diseases and heart failure because to date the evidence-based clinical knowledge is most advanced in these particular areas. Differences between men and women and over the life span were considered in the recommendations as were influences of cognitive capability and the interactive and synergistic impact of classical somatic risk factors on the affective comorbidity in heart disease patients. Results: A IA recommendation (recommendation grade I and evidence grade A) was given for the need to consider psychosocial risk factors in the estimation of coronary risks as etiological and prognostic risk factors. Furthermore, for the recommendation to routinely integrate psychosocial patient management into the care of heart surgery patients because in these patients, comorbid affective disorders (e.g. depression, anxiety and post-traumatic stress disorder) are highly prevalent and often have a malignant prognosis. A IB recommendation was given for the treatment of psychosocial risk factors aiming to prevent the onset of CHD, particularly if the psychosocial risk factor is harmful in itself (e.g. depression) or constrains the treatment of the somatic risk factors. Patients with acute and chronic CHD should be offered anti-depressive medication if these patients suffer from medium to severe states of depression and in this case medication with selective reuptake inhibitors should be given. In the long-term course of treatment with implanted cardioverter defibrillators (ICDs) a subjective health technology assessment is warranted. In particular, the likelihood of affective comorbidities and the onset of psychological crises should be carefully considered. Conclusions: The present state of the art paper presents an update of current empirical evidence in psychocardiology. The paper provides evidence-based recommendations for the integration of psychosocial factors into cardiological practice and highlights areas of high priority. The evidence for estimating the efficiency for psychotherapeutic and psychopharmacological interventions has increased substantially since the first release of the policy document but is, however, still weak. There remains an urgent need to establish curricula for physician competence in psychodiagnosis, communication and referral to ensure that current psychocardiac knowledge is translated into the daily routine.},
  language  = {en}
}
@article{RauchSalzwedelBjarnasonWehrensetal.2021,
  author    = {Rauch, Bernhard and Salzwedel, Annett and Bjarnason-Wehrens, Birna and Albus, Christian and Meng, Karin and Schmid, Jean-Paul and Benzer, Werner and Hackbusch, Matthes and Jensen, Katrin and Schwaab, Bernhard and Altenberger, Johann and Benjamin, Nicola and Bestehorn, Kurt and Bongarth, Christa and D{\"o}rr, Gesine and Eichler, Sarah and Einwang, Hans-Peter and Falk, Johannes and Glatz, Johannes and Gielen, Stephan and Grilli, Maurizio and Gr{\"u}nig, Ekkehard and Guha, Manju and Hermann, Matthias and Hoberg, Eike and H{\"o}fer, Stefan and Kaemmerer, Harald and Ladwig, Karl-Heinz and Mayer-Berger, Wolfgang and Metzendorf, Maria-Inti and Nebel, Roland and Neidenbach, Rhoia Clara and Niebauer, Josef and Nixdorff, Uwe and Oberhoffer, Renate and Reibis, Rona and Reiss, Nils and Saure, Daniel and Schlitt, Axel and V{\"o}ller, Heinz and K{\"a}nel, Roland von and Weinbrenner, Susanne and Westphal, Ronja},
  title     = {Cardiac rehabilitation in German speaking countries of Europe — evidence-based guidelines from Germany, Austria and Switzerland LLKardReha-DACH — Part 1},
  series = {Journal of Clinical Medicine},
  volume    = {10},
  journal   = {Journal of Clinical Medicine},
  number    = {10},
  issn      = {2077-0383},
  doi       = {10.3390/jcm10102192},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-239709},
  year      = {2021},
  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.},
  language  = {en}
}