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Rauch B, Salzwedel A, Bjarnason-Wehrens B, et al. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1. J Clin Med. 2021;10(10)doi: 10.3390/jcm10102192.
Rauch, B., Salzwedel, A., Bjarnason-Wehrens, B., Albus, C., Meng, K., Schmid, J. P., Benzer, W., Hackbusch, M., Jensen, K., Schwaab, B., Altenberger, J., Benjamin, N., Bestehorn, K., Bongarth, C., Dörr, G., Eichler, S., Einwang, H. P., Falk, J., Glatz, J., Gielen, S., Grilli, M., Grünig, E., Guha, M., Hermann, M., Hoberg, E., Höfer, S., Kaemmerer, H., Ladwig, K. H., Mayer-Berger, W., Metzendorf, M. I., Nebel, R., Neidenbach, R. C., Niebauer, J., Nixdorff, U., Oberhoffer, R., Reibis, R., Reiss, N., Saure, D., Schlitt, A., Völler, H., von Känel, R., Weinbrenner, S., Westphal, R., & On Behalf Of The Cardiac Rehabilitation Guideline Group. (2021). Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1. Journal of clinical medicine, 10(10), . https://doi.org/10.3390/jcm10102192
Rauch, Bernhard, et al. "Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1." Journal of clinical medicine vol. 10,10 (2021). doi: https://doi.org/10.3390/jcm10102192
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, On Behalf Of The Cardiac Rehabilitation Guideline Group. Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1. J Clin Med. 2021 May 19;10(10). doi: 10.3390/jcm10102192. PMID: 34069561; PMCID: PMC8161282.
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J Clin Med. 2021 May 19;10(10). doi: 10.3390/jcm10102192.

Cardiac Rehabilitation in German Speaking Countries of Europe-Evidence-Based Guidelines from Germany, Austria and Switzerland LLKardReha-DACH-Part 1.

Journal of clinical medicine

Bernhard Rauch, Annett Salzwedel, Birna Bjarnason-Wehrens, Christian Albus, Karin Meng, Jean-Paul Schmid, Werner Benzer, Matthes Hackbusch, Katrin Jensen, Bernhard Schwaab, Johann Altenberger, Nicola Benjamin, Kurt Bestehorn, Christa Bongarth, Gesine Dörr, Sarah Eichler, Hans-Peter Einwang, Johannes Falk, Johannes Glatz, Stephan Gielen, Maurizio Grilli, Ekkehard Grünig, Manju Guha, Matthias Hermann, Eike Hoberg, Stefan Höfer, Harald Kaemmerer, Karl-Heinz Ladwig, Wolfgang Mayer-Berger, Maria-Inti Metzendorf, Roland Nebel, Rhoia Clara Neidenbach, Josef Niebauer, Uwe Nixdorff, Renate Oberhoffer, Rona Reibis, Nils Reiss, Daniel Saure, Axel Schlitt, Heinz Völler, Roland von Känel, Susanne Weinbrenner, Ronja Westphal, On Behalf Of The Cardiac Rehabilitation Guideline Group

Affiliations

  1. Institut für Herzinfarktforschung Ludwigshafen, D-67063 Ludwigshafen, Germany.
  2. Zentrum für Ambulante Rehabilitation, ZAR Trier GmbH, D-54292 Trier, Germany.
  3. Department of Rehabilitation Medicine, Faculty of Health Sciences Brandenburg, University of Potsdam, D-14469 Potsdam, Germany.
  4. Institut für Kreislaufforschung und Sportmedizin, Abt. Präventive und rehabilitative Sport- und Leistungsmedizin, Deutsche Sporthochschule Köln, D-50937 Köln, Germany.
  5. Department of Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital, D-50937 Köln, Germany.
  6. Institut für Klinische Epidemiologie und Biometrie (IKE-B), Universität Würzburg, D-97078 Würzburg, Germany.
  7. Klinik Barmelweid AG, CH-5017 Barmelweid, Switzerland.
  8. Reha-Klinik Montafon, A-6780 Schruns, Austria.
  9. Institute of Medical Biometry and Informatics (IMBI), University of Heidelberg, D-69120 Heidelberg, Germany.
  10. Curschmann Klinik Dr. Guth GmbH & Co KG, D-23669 Timmendorfer Strand, Germany.
  11. Rehabilitationszentrum Großgmain, A-5084 Großgmain, Austria.
  12. Zentrum für Pulmonale Hypertonie, Thorax-Klinik am Universitätsklinikum Heidelberg, D-69126 Heidelberg, Germany.
  13. Institut für Klinische Pharmakologie, Technische Universität Dresden, Fiedlerstraße 42, D-01307 Dresden, Germany.
  14. Klinik Höhenried gGmbH, Rehabilitationszentrum am Starnberger See, D-82347 Bernried, Germany.
  15. Alexianer St. Josefs-Krankenhaus Potsdam-Sanssouci, D-14471 Potsdam, Germany.
  16. Deutsche Rentenversicherung Bund (DRV-Bund), D-10709 Berlin, Germany.
  17. Reha-Zentrum Seehof der Deutschen Rentenversicherung Bund, D-14513 Teltow, Germany.
  18. Klinikum Lippe, Standort Detmold, D-32756 Detmold, Germany.
  19. Universitätsbibliothek, Universitätsmedizin Mannheim, D-68167 Mannheim, Germany.
  20. Reha-Zentrum am Sendesaal, D-28329 Bremen, Germany.
  21. Klinik für Kardiologie, Universitätsspital Zürich, Rämistrasse 100, CH-8091 Zürich, Switzerland.
  22. Wismarstraße 13, D-24226 Heikendorf, Germany.
  23. Universitätsklinik für Medizinische Psychologie und Psychotherapie, Medizinische Universität Innsbruck, A-6020 Innsbruck, Austria.
  24. Klinik für Angeborene Herzfehler und Kinderkardiologie, Deutsches Herzzentrum München, Klinik der Technischen Universität München, D-80636 München, Germany.
  25. Department of Psychosomatic Medicine and Psychotherapy, Klinikum rechts der Isar, Technische Universität München (TUM) Langerstraße 3, D-81675 Munich, Germany.
  26. Klinik Roderbirken der Deutschen Rentenversicherung Rheinland, D-42799 Leichlingen, Germany.
  27. Cochrane Metabolic and Endocrine Disorders Group, Institute of General Practice (ifam), Medical Faculty of the Heinrich-Heine University, Werdener Straße. 4, D-40227 Düsseldorf, Germany.
  28. Hermann-Albrecht-Klinik METTNAU, Medizinische Reha-Einrichtungen der Stadt Radolfzell, D-73851 Radolfzell, Germany.
  29. Institut für Sportwissenschaft, Universität Wien, Auf der Schmelz 6 (USZ I), AU-1150 Wien, Austria.
  30. Universitätsinstitut für Präventive und Rehabilitative Sportmedizin, Uniklinikum Salzburg Paracelsus Medizinische Privatuniversität, A-5020 Salzburg, Austria.
  31. EPC GmbH, European Prevention Center, Medical Center Düsseldorf, D-40235 Düsseldorf, Germany.
  32. Lehrstuhl für Präventive Pädiatrie, Fakultät für Sport- und Gesundheitswissenschaften, Technische Universität München, D-80992 München, Germany.
  33. Kardiologische Gemeinschaftspraxis Am Park Sanssouci, D-14471 Potsdam, Germany.
  34. Schüchtermann-Schiller'sche Kliniken, Ulmenallee 5-12, D-49214 Bad Rothenfelde, Germany.
  35. Paracelsus Harz-Klinik Bad Suderode GmbH, D-06485 Quedlinburg, Germany.
  36. Klinik am See, D-15562 Rüdersdorf, Germany.
  37. Klinik für Konsiliarpsychiatrie und Psychosomatik, Universitätsspital Zürich, CH-8091 Zürich, Switzerland.
  38. Herzzentrum Segeberger Kliniken, D-23795 Bad Segeberg, Germany.

PMID: 34069561 PMCID: PMC8161282 DOI: 10.3390/jcm10102192

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 "

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.

Keywords: ICD-CRT; adults with congenital heart disease; cardiac rehabilitation standards; chronic heart failure; coronary artery disease; heart transplantation; heart valve repair; myocarditis; peripheral artery disease; pulmonary hypertension; scientific guidelines; secondary prevention; ventricular assist device

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