25 results on '"Bongarth C"'
Search Results
2. Curriculum Kardiologie: 2., aktualisierte Auflage
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Werdan, K., Baldus, St., Bauersachs, J., Baumgartner, H., Bongarth, C. M., Buerke, M., Dörr, R., Duncker, D., Eckardt, L., El-Armouche, A., Elsässer, A., Fach, A., Flachskampf, F. A., Gabelmann, M., Griebenow, R., Heinemann-Meerz, S., Hoffmeister, H. M., Katus, H. A., Kaul, N., Krämer, L.-I., Kuhn, B., Lange, T., Lehmann, L. H., Lugenbiel, P., Michels, G., Müller-Werdan, U., Oldenburg, O., Rittger, H., Rottbauer, W., Rybak, K., Sack, S., Skobel, C. E., Smetak, N., Thiele, H., Tiefenbacher, C., Tiemann, K., Voelker, W., Zeiher, A., and Frey, N.
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- 2020
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3. Kommentar zu den Leitlinien (2018) der Europäischen Gesellschaft für Kardiologie (ESC) und der Europäischen Gesellschaft für Hypertonie (ESH) für das Management der arteriellen Hypertonie
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Mahfoud, F., Böhm, M., Bongarth, C. M., Bosch, R., Schmieder, R. E., Schunkert, H., Stellbrink, C., Trenkwalder, P., Vonend, O., Weil, J., and Kreutz, R.
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- 2019
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4. Curriculum Sportkardiologie
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Burgstahler, C., Pressler, A., Berrisch-Rahmel, S., Mellwig, K.-P., Bongarth, C., Halle, M., Niebauer, J., Hambrecht, R., Gielen, S., Steinacker, J., and Scharhag, J.
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- 2019
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5. Rehabilitationsstandards für die Anschlussheilbehandlung und allgemeine Rehabilitation von Patienten mit einem Herzunterstützungssystem (VAD – ventricular assist device)
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Willemsen, Detlev, Cordes, C., Bjarnason-Wehrens, B., Knoglinger, E., Langheim, E., Marx, R., Reiss, N., Schmidt, T., Workowski, A., Bartsch, P., Baumbach, C., Bongarth, C., Phillips, H., Radke, R., Riedel, M., Schmidt, S., Skobel, E., Toussaint, C., and Glatz, J.
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- 2016
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6. Curriculum Kardiologie
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Werdan, K., Baldus, St., Bauersachs, J., Baumgartner, H., Bongarth, C. M., Buerke, M., Dörr, R., Duncker, D., Eckardt, L., El-Armouche, A., Elsässer, A., Fach, A., Flachskampf, F. A., Gabelmann, M., Griebenow, R., Heinemann-Meerz, S., Hoffmeister, H. M., Katus, H. A., Kaul, N., Krämer, L.-I., Kuhn, B., Lange, T., Lehmann, L. H., Lugenbiel, P., Michels, G., Müller-Werdan, U., Oldenburg, O., Rittger, H., Rottbauer, W., Rybak, K., Sack, S., Skobel, C. E., Smetak, N., Thiele, H., Tiefenbacher, C., Tiemann, K., Voelker, W., Zeiher, A., and Frey, N.
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(Muster-)Weiterbildungsordnung ,Allgemeine Kardiologie ,Bundesärztekammer (BÄK) ,German Cardiac Society (DGK) ,Zusatz-Weiterbildung Kardiale Magnetresonanztomographie ,General cardiology ,Deutsche Gesellschaft für Kardiologie – Herz- und Kreislaufforschung e. V. (DGK) ,German Medical Association (BÄK) ,Curriculum ,Zusatz-Weiterbildung Spezielle Kardiologie für Erwachsene mit angeborenen Herzfehlern (EMAH) ,Specialized educational program of the BÄK “Treatment of Adults with Congenital Heart Disease” ,Specialized educational program of the BÄK “Cardiac Magnetic Resonance Imaging” - Abstract
Die aktualisierte zweite Auflage des „Curriculum Kardiologie“ – Erstauflage 2013 – möchte aus Sicht der Fachgesellschaft aufzeigen, welche Kompetenzen ein Kardiologe heute beherrschen sollte. Sehr zu begrüßen ist, dass in dieser zweiten Auflage nun auch Vertreter der Young DGK als Autoren mitgearbeitet haben. Die zunehmende Spezialisierung innerhalb der Kardiologie darf dabei jedoch nur die eine Seite der Medaille darstellen: Auch weiterhin muss es ein gemeinsames Fundament der Kardiologie geben, eingebettet in das Fach „Innere Medizin“. Dieses Fundament beinhaltet den Grundstock an theoretischen Kenntnissen, an praktischen Fähigkeiten (Kompetenzlevel I–III) und an beruflich-professioneller Einstellung des (angehenden) Kardiologen. Neues für die Weiterbildung ist seit der Erstauflage des Curriculums 2013 hinzugekommen, so z. B. ein Kapitel „Digitale Kardiologie“, die neu in die Muster-Weiterbildungsordnung für den Kardiologen aufgenommene Weiterbildung in „Psychokardiologie“ und schließlich auch die explizite Formulierung der Partizipativen Entscheidungsfindung („Shared Decision Making“) im Interesse des Herzpatienten. Dem Weiterzubildenden soll das Curriculum die Möglichkeit geben, seine Weiterbildungszeit so effizient wie möglich zu strukturieren und das Erlernte anschließend im Sinne eines „berufslebenslangen“ Qualifizierens zu bewahren und auszubauen. Das Curriculum möchte aber auch die Weiterbilder und die Ärztekammern erreichen und aufzeigen, welche Inhalte und Fertigkeiten nach Ansicht der Deutschen Gesellschaft für Kardiologie – Herz- und Kreislaufforschung (DGK) in der Weiterbildung zum Kardiologen vermittelt werden sollen. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s12181-020-00425-w) enthält ein ausführliches Inhaltsverzeichnis, ein Abkürzungsverzeichnis und ein Literaturverzeichnis. Beitrag und Zusatzmaterial stehen Ihnen auf www.springermedizin.de zur Verfügung. Bitte geben Sie dort den Beitragstitel in die Suche ein, das Zusatzmaterial finden Sie beim Beitrag unter „Ergänzende Inhalte“.
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- 2020
7. Erratum zu: Curriculum Sportkardiologie
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Burgstahler, C., Pressler, A., Berrisch-Rahmel, S., Mellwig, K.-P., Bongarth, C., Halle, M., Niebauer, J., Hambrecht, R., Gielen, S., Steinacker, J. M., and Scharhag, J.
- Published
- 2019
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8. Curriculum Cardiology 2nd updated Edition
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Werdan, K., Baldus, St., Bauersachs, J., Baumgartner, H., Bongarth, C. M., Buerke, M., Dorr, R., Duncker, D., Eckardt, L., El-Armouche, A., Elsasser, A., Fach, A., Flachskampf, F. A., Gabelmann, M., Griebenow, R., Heinemann-Meerz, S., Hoffmeister, H. M., Katus, H. A., Kaul, N., Kramer, L. -I., Kuhn, B., Lange, T., Lehmann, L. H., Lugenbiel, P., Michels, G., Muller-Werdan, U., Oldenburg, O., Rittger, H., Rottbauer, W., Rybak, K., Sack, S., Skobel, C. E., Smetak, N., Thiele, H., Tiefenbacher, C., Tiemann, K., Voelker, W., Zeiher, A., Frey, N., Werdan, K., Baldus, St., Bauersachs, J., Baumgartner, H., Bongarth, C. M., Buerke, M., Dorr, R., Duncker, D., Eckardt, L., El-Armouche, A., Elsasser, A., Fach, A., Flachskampf, F. A., Gabelmann, M., Griebenow, R., Heinemann-Meerz, S., Hoffmeister, H. M., Katus, H. A., Kaul, N., Kramer, L. -I., Kuhn, B., Lange, T., Lehmann, L. H., Lugenbiel, P., Michels, G., Muller-Werdan, U., Oldenburg, O., Rittger, H., Rottbauer, W., Rybak, K., Sack, S., Skobel, C. E., Smetak, N., Thiele, H., Tiefenbacher, C., Tiemann, K., Voelker, W., Zeiher, A., and Frey, N.
- Abstract
The updated second edition of the Curriculum cardiology, first edition 2013, aims to show which competences a cardiologist should nowadays master. It is very pleasing that in this second edition representatives of the Young German Cardiac Society (Young DGK) have contributed as authors. The increasing specialization within cardiology should, however, only represent one side of the coin: there must also still be a common foundation of cardiology, embedded in the discipline internal medicine. This foundation includes the basis of theoretical knowledge, practical skills (competence levels I-III) and an occupational and professional attitude of the (prospective) cardiologist. New additions to the advanced training since the first edition of the curriculum in 2013 are, for example a chapter on digital cardiology, the further training in psychocardiology, which was newly introduced into the model further training regulations and finally also the explicit formulation of shared decision making in the interests of cardiac patients. The curriculum should give the prospective cardiologist the possibility to structure the further training as efficiently as possible and ultimately to retain and expand that which has been learned in the sense of a professional lifelong qualification. The curriculum also aims to reach the trainers and the Medical Councils and demonstrate which contents and skills should be mediated in the further training to become a cardiologist from the perspective of the German Cardiac Society (DGK).
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- 2020
9. Significance of patient-reported outcomes for occupational resumption and quality of life after cardiac rehabilitation
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Salzwedel, A, primary, Koran, I, additional, Langheim, E, additional, Schlitt, A, additional, Nothroff, J, additional, Bongarth, C, additional, Wrenger, M, additional, Wegscheider, K, additional, and Voller, H, additional
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- 2020
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10. The current LDL-C target <1.4mmol/l of the ESC is achieved in less than 16% of patients with Coronary Heart Disease despite effective lipid-lowering therapy: data from the LLT-R registry
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Noack, F, primary, Schwaab, B, additional, Voeller, H, additional, Eckrich, K, additional, Guha, M, additional, Bongarth, C, additional, Heinze, V, additional, and Schlitt, A, additional
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- 2020
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11. Quantifizierung des Rehabilitationserfolges von kardiologischen Patienten im berufsfähigen Alter – erste Ergebnisse der OutCaRe-Registerstudie
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Zoch-Lesniak, B, Völler, H, Schlitt, A, Bongarth, C, Schröder, K, Langheim, E, Nothroff, J, Wrenger, M, Marx, R, Westphal, R, Schubmann, R, Schikora, M, Spörl-Dönch, S, Hadzic, M, and Salzwedel, A
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ddc: 610 ,610 Medical sciences ,Medicine - Abstract
Hintergrund: Eine Rehabilitationsmaßnahme bei Patienten im berufsfähigen Alter zielt auf die Rückkehr in den Beruf ab. Um dieses Ziel zu erreichen, sollen in der kardiologischen Rehabilitation (CR) physische, psychische und sozialmedizinische Aspekte der Erkrankung positiv beeinflusst[zum vollständigen Text gelangen Sie über die oben angegebene URL], 18. Deutscher Kongress für Versorgungsforschung (DKVF)
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- 2019
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12. Kommentar zu den Leitlinien (2018) der Europäischen Gesellschaft für Kardiologie (ESC) und der Europäischen Gesellschaft für Hypertonie (ESH) für das Management der arteriellen Hypertonie
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Mahfoud, F., primary, Böhm, M., additional, Bongarth, C. M., additional, Bosch, R., additional, Schmieder, R. E., additional, Schunkert, H., additional, Stellbrink, C., additional, Trenkwalder, P., additional, Vonend, O., additional, Weil, J., additional, and Kreutz, R., additional
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- 2019
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13. Medical Rehabilitation in Adults with Congenital Heart Disease (ACHD).
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Neidenbach R, Andric D, Einwang H, Kodolitsch Y, Bongarth C, Oberhoffer R, Hischke S, Hofbeck M, Ewert P, Kaemmerer H and Neidenbach R, Andric D, Einwang H, Kodolitsch Y, Bongarth C, Oberhoffer R, Hischke S, Hofbeck M, Ewert P, Kaemmerer H
- Published
- 2017
14. Prävention – Eine gemeinsame Herausforderung
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Halle, M, primary and Bongarth, C, additional
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- 2016
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15. Prävention – Eine gemeinsame Herausforderung
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Bongarth C and Halle M
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business.industry ,Medicine ,Physical Therapy, Sports Therapy and Rehabilitation ,Orthopedics and Sports Medicine ,business - Published
- 2016
16. Pilot study of rehabilitation outcomes in 205 adults with congenital heart disease (ACHD)
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Andric D, Einwang HP, von Kodolitsch Y, Bongarth C, Hischke S, Oberhoffer R, Hofbeck M, Pujol C, Hörer C, Ewert P, Kaemmerer H and Andric D, Einwang HP, von Kodolitsch Y, Bongarth C, Hischke S, Oberhoffer R, Hofbeck M, Pujol C, Hörer C, Ewert P, Kaemmerer H
- Published
- 2014
17. Telemedical cardiac risk assessment by implantable cardiac monitors in patients after myocardial infarction with autonomic dysfunction (SMART-MI-DZHK9): a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial.
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Bauer A, Sappler N, von Stülpnagel L, Klemm M, Schreinlechner M, Wenner F, Schier J, Al Tawil A, Dolejsi T, Krasniqi A, Eiffener E, Bongarth C, Stühlinger M, Huemer M, Gori T, Wakili R, Sahin R, Schwinger R, Lutz M, Luik A, Gessler N, Clemmensen P, Linke A, Maier LS, Hinterseer M, Busch MC, Blaschke F, Sack S, Lennerz C, Licka M, Tilz RR, Ukena C, Ehrlich JR, Zabel M, Schmidt G, Mansmann U, Kääb S, Rizas KD, and Massberg S
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- Aged, Austria, Female, Germany, Humans, Male, Middle Aged, Prospective Studies, Arrhythmias, Cardiac diagnosis, Monitoring, Physiologic methods, Myocardial Infarction complications, Myocardial Infarction physiopathology, Risk Assessment methods, Telemedicine methods
- Abstract
Background: Cardiac autonomic dysfunction after myocardial infarction identifies patients at high risk despite only moderately reduced left ventricular ejection fraction. We aimed to show that telemedical monitoring with implantable cardiac monitors in these patients can improve early detection of subclinical but prognostically relevant arrhythmic events., Methods: We did a prospective investigator-initiated, randomised, multicentre, open-label, diagnostic trial at 33 centres in Germany and Austria. Survivors of acute myocardial infarction with left ventricular ejection fraction of 36-50% had biosignal analysis for assessment of cardiac autonomic function. Patients with abnormal periodic repolarisation dynamics (≥5·75 deg
2 ) or abnormal deceleration capacity (≤2·5 ms) were randomly assigned (1:1) to telemedical monitoring with implantable cardiac monitors or conventional follow-up. Primary endpoint was time to detection of serious arrhythmic events defined by atrial fibrillation 6 min or longer, atrioventricular block class IIb or higher and fast non-sustained (>187 beats per min; ≥40 beats) or sustained ventricular tachycardia or fibrillation. This study is registered with ClinicalTrials.gov, NCT02594488., Findings: Between May 12, 2016, and July 20, 2020, 1305 individuals were screened and 400 patients at high risk were randomly assigned (median age 64 years [IQR 57-73]); left ventricular ejection fraction 45% [40-48]) to telemedical monitoring with implantable cardiac monitors (implantable cardiac monitor group; n=201) or conventional follow-up (control group; n=199). During median follow-up of 21 months, serious arrhythmic events were detected in 60 (30%) patients of the implantable cardiac monitor group and 12 (6%) patients of the control group (hazard ratio 6·33 [IQR 3·40-11·78]; p<0·001). An improved detection rate by implantable cardiac monitors was observed for all types of serious arrhythmic events: atrial fibrillation 6 min or longer (47 [23%] patients vs 11 [6%] patients; p<0·001), atrioventricular block class IIb or higher (14 [7%] vs 0; p<0·001) and ventricular tachycardia or ventricular fibrillation (nine [4%] patients vs two [1%] patients; p=0·054)., Interpretation: In patients at high risk after myocardial infarction and cardiac autonomic dysfunction but only moderately reduced left ventricular ejection fraction, telemedical monitoring with implantable cardiac monitors was highly effective in early detection of subclinical, prognostically relevant serious arrhythmic events., Funding: German Centre for Cardiovascular Research (DZHK) and Medtronic Bakken Research Center., Competing Interests: Declaration of interests AB received funding from Medtronic Bakken Research Center as co-funding for the SMART-MI trial (providing implantable cardiac monitors and staff cost for implantable cardiac monitors core lab); and speaker honoraria from Bayer, Boerhinger Ingelheim, Edwards, Medtronic, and Novartis. MSt received consulting fees, speaker honoraria, and travel expenses from Medtronic. RW received grants from German Centre for Cardiovascular Research, Bristol Myers Squibb–Pfizer, and Grant Boston Scientific; speaker honoraria from Biotronik, Boston Scientific, Medtronic, Abiomed, Bristol Myers Squibb–Pfizer, Boehringer Ingelheim, Daiichi Sankyo, Bayer, and Novartis; and travel expenses from Boston Scientific, Bristol Myers Squibb–Pfizer, Boehringer Ingelheim, Daiichi Sankyo, and Bayer. RW participated on advisory boards for Biotronik, Philips, Boehringer Ingelheim, and Daiichi Sankyo. ALu received grants and consulting fees from Boston Scientific and Biosense Webster; speaker honoraria from Boston Scientific, Biosense Webster, and Medtronic; travel expenses from Boston Scientific; and participated on data safety monitoring boards and societies for Boston Scientific. NG received grants from Boston Scientific and Medtronic and travel expenses from Bayer Vital. PC received research grants from Philips. LSM received grants from the German Research Foundation and the EU; speaker honoraria from Bayer, Astra Zeneca, Pfizer, Bristol Myers Squibb, Daiichi Sankyo, and Boehringer Ingelheim; travel expenses from Servier, Boehringer Ingelheim, and Vifor; and participated on data safety monitoring boards for Else Kröner-Fresenius-Stiftung. LSM is stock holder of Bayer and Fresenius Medical Care. MCB received consulting fees from Medtronic and Boston Scientific; speaker honoraria from Medtronic, Boston Scientific, and St Jude Medical; travel expenses from Medtronic, Jonhson & Johnson, Boston Scientific, and St Jude Medical; and participated on advisory boards for Medtronic. CL is member of the Expert Panel for medical devices for the European Commission. CU received consulting fees and speaker honoraria from Medtronic. JRE received consulting fees and speaker honoraria from Medtronic, Abbott, and Boston Scientific. UM received grants from German Centre for Cardiovascular Research (DZHK). All other authors declare no competing interests., (Copyright © 2022 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license. Published by Elsevier Ltd.. All rights reserved.)- Published
- 2022
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18. Lessons from the short- and mid-term outcome of medical rehabilitation in adults with congenital heart disease.
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Freilinger S, Andric D, Andonian C, Beckmann J, Bongarth C, Einwang HP, Ewert P, Hofbeck M, Kaemmerer AS, Nagdyman N, Oberhoffer R, von Kodolitsch Y, Kaemmerer H, and Neidenbach R
- Abstract
Background: The number of adults with congenital heart disease (ACHD) is steadily increasing. Over their life-time, many of the affected patients require medical rehabilitation after interventional or surgical treatment of residua, sequels or complications of their congenital heart defect (CHD). However, up to now only scarce data exist about indication, performance and outcomes of cardiac rehabilitation in ACHD., Methods: The course and outcome of rehabilitation after previous interventional or surgical treatment in ACHD was analyzed in a retrospective cohort study., Results: Two hundred and five ACHD {54% female; mean age 34±12 [16-68] years} with mild (23.9%), moderate (35.1%) or severe CHD (41.0%), of whom 32% had complex CHD, 21% right-ventricular outflow tract obstructions, 20% pre-tricuspid shunts, 18% left heart or aortic anomalies, 9% post-tricuspid shunts and 2% other congenital cardiac anomalies were included into analysis. The main indications for rehabilitation were a preceding surgical (92%) or interventional (3%) treatment of the underlying CHD immediately before rehabilitation. During rehabilitation, no severe complications occurred. The number of patients in function class I/II increased from 189 to 200 and decreased in class III/IV from 16 to 5. Cardiac medication could be reduced or stopped after rehabilitation in 194 patients, with the exception of ACE-inhibitors. There was an improvement in cardiovascular risk factors. While before medical treatment 77% (n=157) patients were capable of working, the number increased to 82% [168] at the end of rehabilitation. Throughout a follow-up 9.3% (n=19) of patients needed further cardiac interventions., Conclusions: The current study provided for the first time comprehensive data on the course of rehabilitation in a large cohort of ACHD after surgical or interventional treatment. The overall outcome of ACHD after rehabilitation was uneventful and favorable. Further research is required to assess the clinical long-term outcome, the impact of rehabilitation on the quality of life, disease coping and employment. The results of this study can serve as a benchmark for the development of specific rehabilitation programs in ACHD., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/cdt-20-727). The series “Current Management Aspects in Adult Congenital Heart Disease (ACHD): Part IV” was commissioned by the editorial office without any funding or sponsorship. YVK serves as an unpaid editorial board member of Cardiovascular Diagnosis and Therapy from February 2018 to January 2022. HK serves as an unpaid editorial board member of Cardiovascular Diagnosis and Therapy from February 2018 to January 2022. YVK and HK served as the unpaid Guest Editors of the series. The authors have no other conflicts of interest to declare., (2021 Cardiovascular Diagnosis and Therapy. All rights reserved.)
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- 2021
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19. Efficacy of Lipid-Lowering Therapy during Cardiac Rehabilitation in Patients with Diabetes Mellitus and Coronary Heart Disease.
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Wittlinger T, Schwaab B, Völler H, Bongarth C, Heinze V, Eckrich K, Guha M, Richter M, and Schlitt A
- Abstract
Background: Cardiac rehabilitation (CR) in patients with coronary heart disease (CHD) increases adherence to a healthy lifestyle and to secondary preventive medication. A notable example of such medication is lipid-lowering therapy (LLT). LLT during CR improves quality of life and prognosis, and thus is particularly relevant for patients with diabetes mellitus, which is a major risk factor for CHD., Design: A prospective, multicenter registry study with patients from six rehabilitation centers in Germany., Methods: During CR, 1100 patients with a minimum age of 18 years and CHD documented by coronary angiography were included in a LLT registry., Results: In 369 patients (33.9%), diabetes mellitus was diagnosed. Diabetic patients were older (65.5 ± 9.0 vs. 62.2 ± 10.9 years, p < 0.001) than nondiabetic patients and were more likely to be obese (BMI: 30.2 ± 5.2 kg/m
2 vs. 27.8 ± 4.2 kg/m2 , p < 0.001). Analysis indicated that diabetic patients were more likely to show LDL cholesterol levels below 55 mg/dL than patients without diabetes at the start of CR (Odds Ratio (OR) 1.9; 95% CI 1.3 to 2.9) until 3 months of follow-up (OR 1.9; 95% CI 1.2 to 2.9). During 12 months of follow-up, overall and LDL cholesterol levels decreased within the first 3 months and remained at the lower level thereafter ( p < 0.001), irrespective of prevalent diabetes. At the end of the follow-up period, LDL cholesterol did not differ significantly between patients with or without diabetes mellitus ( p = 0.413)., Conclusion: Within 3 months after CR, total and LDL cholesterol were significantly reduced, irrespective of prevalent diabetes mellitus. In addition, CHD patients with diabetes responded faster to LTT than nondiabetic patients, suggesting that diabetic patients benefit more from LLT treatment during CR.- Published
- 2021
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20. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1.
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Rauch B, Salzwedel A, Bjarnason-Wehrens B, Albus C, Meng K, Schmid JP, Benzer W, Hackbusch M, Jensen K, Schwaab B, Altenberger J, Benjamin N, Bestehorn K, Bongarth C, Dörr G, Eichler S, Einwang HP, Falk J, Glatz J, Gielen S, Grilli M, Grünig E, Guha M, Hermann M, Hoberg E, Höfer S, Kaemmerer H, Ladwig KH, Mayer-Berger W, Metzendorf MI, Nebel R, Neidenbach RC, Niebauer J, Nixdorff U, Oberhoffer R, Reibis R, Reiss N, Saure D, Schlitt A, Völler H, von Känel R, Weinbrenner S, Westphal R, and On Behalf Of The Cardiac Rehabilitation Guideline Group
- 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.
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- 2021
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21. Patient-reported outcomes predict return to work and health-related quality of life six months after cardiac rehabilitation: Results from a German multi-centre registry (OutCaRe).
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Salzwedel A, Koran I, Langheim E, Schlitt A, Nothroff J, Bongarth C, Wrenger M, Sehner S, Reibis R, Wegscheider K, and Völler H
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- Cardiovascular Diseases epidemiology, Female, Germany epidemiology, Humans, Male, Middle Aged, Prospective Studies, Registries, Return to Work, Cardiac Rehabilitation, Patient Reported Outcome Measures, Quality of Life
- Abstract
Background: Multi-component cardiac rehabilitation (CR) is performed to achieve an improved prognosis, superior health-related quality of life (HRQL) and occupational resumption through the management of cardiovascular risk factors, as well as improvement of physical performance and patients' subjective health. Out of a multitude of variables gathered at CR admission and discharge, we aimed to identify predictors of returning to work (RTW) and HRQL 6 months after CR., Design: Prospective observational multi-centre study, enrolment in CR between 05/2017 and 05/2018., Method: Besides general data (e.g. age, sex, diagnoses), parameters of risk factor management (e.g. smoking, hypertension), physical performance (e.g. maximum exercise capacity, endurance training load, 6-min walking distance) and patient-reported outcome measures (e.g. depression, anxiety, HRQL, subjective well-being, somatic and mental health, pain, lifestyle change motivation, general self-efficacy, pension desire and self-assessment of the occupational prognosis using several questionnaires) were documented at CR admission and discharge. These variables (at both measurement times and as changes during CR) were analysed using multiple linear regression models regarding their predictive value for RTW status and HRQL (SF-12) six months after CR., Results: Out of 1262 patients (54±7 years, 77% men), 864 patients (69%) returned to work. Predictors of failed RTW were primarily the desire to receive pension (OR = 0.33, 95% CI: 0.22-0.50) and negative self-assessed occupational prognosis (OR = 0.34, 95% CI: 0.24-0.48) at CR discharge, acute coronary syndrome (OR = 0.64, 95% CI: 0.47-0.88) and comorbid heart failure (OR = 0.51, 95% CI: 0.30-0.87). High educational level, stress at work and physical and mental HRQL were associated with successful RTW. HRQL was determined predominantly by patient-reported outcome measures (e.g. pension desire, self-assessed health prognosis, anxiety, physical/mental HRQL/health, stress, well-being and self-efficacy) rather than by clinical parameters or physical performance., Conclusion: Patient-reported outcome measures predominantly influenced return to work and HRQL in patients with heart disease. Therefore, the multi-component CR approach focussing on psychosocial support is crucial for subjective health prognosis and occupational resumption., Trial Registration: The study was registered at the German Clinical Trial Registry and the International Clinical Trials Registry Platform (ICTRP) of the World Health Organization (DRKS00011418; http://www.drks.de/DRKS00011418, http://apps.who.int/trialsearch/Trial2.aspx?TrialID=DRKS00011418)., Competing Interests: The authors have declared that no competing interests exist.
- Published
- 2020
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22. Performance Measures for Short-Term Cardiac Rehabilitation in Patients of Working Age: Results of the Prospective Observational Multicenter Registry OutCaRe.
- Author
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Zoch-Lesniak B, Dobberke J, Schlitt A, Bongarth C, Glatz J, Spörl-Dönch S, Koran I, Völler H, and Salzwedel A
- Abstract
Objective: To determine immediate performance measures for short-term, multicomponent cardiac rehabilitation (CR) in clinical routine in patients of working age, taking into account cardiovascular risk factors, physical performance, social medicine, and subjective health parameters and to explore the underlying dimensionality., Design: Prospective observational multicenter register study in 12 rehabilitation centers throughout Germany., Setting: Comprehensive 3-week CR., Participants: Patients (N=1586) ≤65 years of age (mean 53.8±7.3y, 77.1% men) in CR (May 2017-May 2018)., Interventions: Not applicable., Main Outcome Measures: Feasibility, defined by data availability for ≥85% of patients (CR admission and discharge), and modifiability based on pre-post comparison (statistical significance, with P value<.01; standardized effect size≥.35; change by ≥5% points in categorical variables). In addition, latent factors were identified using an exploratory factor analysis (EFA)., Results: Based on feasibility and modifiability criteria, smoking behavior, lifestyle change behavior, blood pressure, endurance training load, depression in Patient Health Questionnaire-9 (PHQ-9), the 5-item World Health Organization Well-Being Index (WHO-5), physical and mental health and pain scale of the indicators of rehabilitation status-24 (IRES-24), and self-assessed health prognosis proved to be suitable performance measures. As a result of the EFA, 2 solid factors were identified: (1) subjective mental health including PHQ-9, WHO-5, mental health (IRES-24), mental quality of life, and anxiety and (2) physical health including physical quality of life, physical health and pain scale of IRES-24, and self-assessed occupational prognosis. A third factor represents the blood pressure., Conclusions: We provide a small set of performance measures, that are essentially based on 3 latent factors (subjective mental health, physical health, blood pressure). These performance measures can represent immediate success of comprehensive CR and be applied easily in clinical practice., (© 2020 The Authors.)
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- 2020
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23. [Comments on the guidelines (2018) of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension].
- Author
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Mahfoud F, Böhm M, Bongarth CM, Bosch R, Schmieder RE, Schunkert H, Stellbrink C, Trenkwalder P, Vonend O, Weil J, and Kreutz R
- Subjects
- Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Humans, Cardiology, Hypertension
- Abstract
Arterial hypertension represents one of the most frequent chronic diseases that can lead to complications, such as stroke, dementia, heart attack, heart failure and renal failure. By 2025 the number of hypertensive patients will increase to approximately 1.6 billion people worldwide. The new guidelines of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) on the management of arterial hypertension replace the guidelines of the ESC/ESH from 2013. The 2018 guidelines of the ESC/ESH were adopted by the German Cardiac Society and the German Hypertension League. In these comments national characteristics are worked out and the essential new aspects of the guidelines are critically discussed. These include, for example, the definition of hypertension, the importance of out of office blood pressure measurements, revised blood pressure targets, the modified algorithm for drug treatment and the relevance of device-based hypertension treatments. Important aspects for the management of hypertensive emergencies are also presented.
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- 2019
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24. The Efficacy of Goal Setting in Cardiac Rehabilitation-a Gender-Specific Randomized Controlled Trial.
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Stamm-Balderjahn S, Brünger M, Michel A, Bongarth C, and Spyra K
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- Female, Humans, Male, Middle Aged, Sex Characteristics, Treatment Outcome, Cardiac Rehabilitation methods, Cardiac Rehabilitation psychology, Cardiovascular Diseases psychology, Motivation, Patient Care Planning, Patient Compliance psychology
- Abstract
Background: Patients with coronary heart disease undergo cardiac rehabilitation in order to reduce their cardiovascular risk factors. Often, however, the benefit of rehabilitation is lost over time. It is unclear whether this happens in the same way to men and women. We studied whether the setting of gender-specific behavior goals with an agreement between the doctor and the patient at the end of rehabilitation can prolong its positive effects., Methods: This study was performed with a mixed-method design. It consisted of qualitative interviews and group discussions with patients, doctors and other treating personnel, and researchers, as well as a quantitative, randomized, controlled intervention trial in which data were acquired at four time points (the beginning and end of rehabilitation and then 6 and 12 months later). 545 patients, 262 of them women (48.1%), were included. The patients were assigned to a goal checking group (n = 132), a goal setting group (n = 143), and a control group (n = 270). The primary endpoints were health-related behavior (exercise, diet, tobacco consumption), subjective state of health, and medication adherence. The secondary endpoints included physiological protection and risk factors such as blood pressure, cholesterol (HDL, LDL, and total), blood sugar, HbA1c, and body-mass index., Results: The intervention had no demonstrable effect on the primary or secondary endpoints. The percentage of smokers declined to a similar extent in all groups from the beginning of rehabilitation to 12 months after its end (overall figures: 12.4% to 8.6%, p <0.05). The patients' exercise behavior, diet, and subjective state of health also improved over the entire course of the study. Women had a healthier diet than men. Subgroup analyses indicated a possible effect of the intervention on exercise behavior in women who were employed and in men who were not (p<0.01)., Conclusion: The efficacy of goal setting was not demonstrated. Therefore, no indication for its routine provision can be derived from the study results.
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- 2016
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25. Left ventricular geometry and function before and after mitral valve replacement.
- Author
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Deutsch HJ, Curtius JM, Bongarth C, Behlke E, Borowski A, de Vivie ER, and Hilger HH
- Subjects
- Adult, Aged, Chronic Disease, Echocardiography, Female, Humans, Male, Middle Aged, Mitral Valve Insufficiency diagnostic imaging, Mitral Valve Insufficiency surgery, Mitral Valve Stenosis diagnostic imaging, Mitral Valve Stenosis surgery, Heart Valve Prosthesis, Heart Ventricles diagnostic imaging, Mitral Valve Insufficiency physiopathology, Mitral Valve Stenosis physiopathology, Ventricular Function, Left
- Abstract
Left ventricular geometry and function were assessed in 20 patients with mitral stenosis (MS) and in another 20 patients with mitral insufficiency (MI) five days before and 12 days after mitral valve replacement by transthoracic (TTE) and transesophageal (TEE) echocardiography, as well as late postoperatively (mean: 194 days) by TTE. The continuity of the subvalvular apparatus could not be preserved in any of these patients. In mitral stenosis the area ejection fraction (AEF) in the short axis of the left ventricle (LV) did not change significantly early or late postoperatively. There was a significant lengthening of the left ventricular longitudinal axis in the apical four chamber view whereas the transverse axis remained unchanged. This was likely the result of the discontinuity between the mitral valve and the papillary muscles. AEF and ejection fraction (EF) determined in the four chamber view showed a slight tendency to decrease in the postoperative phase. Patients with mitral insufficiency likewise showed a significant increase of the LV longitudinal diameter postoperatively. In the short axis of the left ventricle and in the apical four chamber view a significant reduction of the AEF was observed. Furthermore, left ventricular EF dropped significantly postoperatively. This decrease was caused by the extension of the LV longitudinal axis accompanied by an enlargement of the transverse diameter as well as by an afterload increase, and a masked impairment of left ventricular function preoperatively. Wall motion analysis of the LV in both groups documented new postoperative hypokinesis especially in the septal segments. At late postoperative examination the hypokinesis disappeared in about 50% of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1994
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