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Rehabilitation (Stuttg) 2014; 53(03): 191-202
DOI: 10.1055/s-0034-1370119
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© Georg Thieme Verlag KG Stuttgart · New York

Rehabilitation nach akutem Myokardinfarkt

Rehabilitation after Acute Myocardial Infarction
R. K. Reibis
1   Kardiologische Gemeinschaftspraxis Am Park Sanssouci Potsdam, Zimmerstraße 7a, 14471 Potsdam
2   Universität Potsdam, Professur für Rehabilitationswissenschaften, Am Neuen Palais 10, 14469 Potsdam
,
C. Gaede-Illig
2   Universität Potsdam, Professur für Rehabilitationswissenschaften, Am Neuen Palais 10, 14469 Potsdam
,
H. Völler
2   Universität Potsdam, Professur für Rehabilitationswissenschaften, Am Neuen Palais 10, 14469 Potsdam
3   Klinik am See Rüdersdorf/Berlin, Rehabilitationszentrum für Innere Medizin, Seebad 84, 15562 Rüdersdorf/Berlin
› Author Affiliations
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Publication History

Publication Date:
12 June 2014 (online)

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Kernaussagen des Manuskripts

  1. Die stationäre und/oder ambulante Rehabilitation von Patienten dient als wesentliche Säule im therapeutischen Kontinuum von Patienten nach akutem Koronarsyndrom.

  2. Durch interprofessionelle Kooperation wird eine Modifikation kardiovaskulärer, verhaltensassoziierter und psychologischer Risikoparameter ermöglicht.

  3. Die Kombination aus bildgebender und funktionsabbildender Diagnostik ist unabdingbar zur prognostischen Risikoeinschätzung insbesondere bei Postinfarktpatienten mit eingeschränkter linksventrikulärer Pumpfunktion.

  4. Die berufliche Wiedereingliederung wird durch die postinfarzielle residuale linksventrikuläre Pumpfunktion, den Bildungsstatus, die psychobiologischen Verhältnisse und ein evtl. implantiertes Aggregat determiniert.

  5. Die Einschätzung der Fahrtauglichkeit von Privat- bzw. Berufskraftfahrern nach ACS ist abhängig von periinfarziellen Komplikationen, aktueller Rhythmusstabilität und der vorliegenden linksventrikulären Ejektionsfraktion.

 

  • Literatur

  • 1 Steg PG, James SK, Atar D et al. ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart Journal 2012; 33: 2569-2619
    PubMedGoogle Scholar
  • 2 Perk J, De Backer G, Gohlke H et al. The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012; 33: 1635-1701
    CrossrefPubMedGoogle Scholar
  • 3 Zeymer U, Hambrecht R, Theres H et al. Therapie des akuten ST-Streckenhebungs-Myokardinfarkts in Krankenhäusern mit und ohne Herzkatheterlabor. Ergebnisse des Deutschen Herzinfarkt-Registers (DHR). Dtsch Med Wochenschr 2013; 138: 1935-1940
    Article in Thieme ConnectPubMedGoogle Scholar
  • 4 Rauch B, Riemer T, Schwaab B et al. Short-term comprehensive cardiac rehabilitation after AMI is associated with reduced 1-year mortality: results from the OMEGA study. Eur J Prev Cardiol 2013; Apr 4. [Epub ahead of print]
    PubMedGoogle Scholar
  • 5 Jünger C, Rauch B, Schneider S et al. Effect of early short-term cardiac rehabilitation after acute ST-elevation and non-ST-elevation myocardial infarction on 1-year mortality. Curr Med Res Opin 2010; 26: 803-811
    CrossrefPubMedGoogle Scholar
  • 6 Heran BS, Chen JMH, Ebrahim S et al. Exercise-based cardiac rehabilitation for coronary heart disease. The Cochrane Database of Syst Rev 2011; 7 CD001800 DOI: 10.1002/14651858. CD001800.pub2.
    PubMedGoogle Scholar
  • 7 Reibis R, Treszl A, Wegscheider K et al. Disparity in risk factor pattern in premature versus late-onset coronary artery disease: a survey of 15,381 patients. Vasc Health Risk Manag 2012; 8: 473-481
    PubMedGoogle Scholar
  • 8 Linden M Hrsg. Therapeutisches Milieu. Healing Environment in medizinischer Rehabilitation und stationärer Behandlung. Berlin: MWV Medizinisch Wissenschaftliche Verlagsgesellschaft mbH & Co. KG; 2011
    Google Scholar
  • 9 Von Eiff W, Schüring S, Greitemann B et al. REIDA-Auswirkungen der DRG-Einführung auf die Rehabilitation. Die Rehabilitation 2011; 50: 213-221
    Article in Thieme ConnectPubMedGoogle Scholar
  • 10 Glatz J, Kamke W, Dovifat C et al. Stationäre kardiologische Rehabilitation: Die meisten Notfälle können vor Ort versorgt werden. Dtsch Arztebl 2003; 100: A-1731/B-1435/C-1351
    PubMedGoogle Scholar
  • 11 http://www.deutsche-rentenversicherung.de/Allgemein/de/Navigation/3_Fachbereiche/01_Sozialmedizin_Forschung/02_reha_qualitaetssicherung/reha_therapiestandards/hintergrund_node.html
    PubMed
  • 12 Light RW. Pleural effusions following cardiac injury and coronary artery bypass graft surgery. Semin Respir Crit Care Med 2001; 22: 664-675
    PubMedGoogle Scholar
  • 13 Löllgen H, Winter UJ, Erdmann E Hrsg. Ergometrie. Belastungsuntersuchungen in Klinik und Praxis. Berlin, Heidelberg, New York, Barcelona, Budapest, Hongkong, London, Milan, Paris, Tokyo: Springer; 1995
    Google Scholar
  • 14 Arena R, Myers J, Guazzi M. The clinical and research applications of aerobic capacity and ventilatory efficiency in heart failure: an evidence-based review. Heart Fail Rev 2008; 13: 245-269
    CrossrefPubMedGoogle Scholar
  • 15 Guazzi M, Myers J, Arena R. Cardiopulmonary exercise testing in the clinical and prognostic assessment of diastolic heart failure. J Am Coll Cardiol 2005; 46: 1883-1890
    CrossrefPubMedGoogle Scholar
  • 16 Milani RV, Lavie CJ, Mehra MR. Cardiopulmonary exercise testing: how do we differentiate the cause of dyspnea?. Circulation 2004; 110: e27-31
    CrossrefPubMedGoogle Scholar
  • 17 Roul G, Germain P, Bareiss P. Does the 6-minute walk test predict the prognosis in patients with NYHA class II or III chronic heart failure?. Am Heart J 1998; 136: 449-457
    CrossrefPubMedGoogle Scholar
  • 18 Bittner V, Weiner DH, Yusuf S et al. Prediction of mortality and morbidity with a 6-minute walk test in patients with left ventricular dysfunction. JAMA 1993; 270: 1702-1707
    CrossrefPubMedGoogle Scholar
  • 19 Mancia G, Fagard R, Narkiewicz K et al. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2013; 31: 1281-1357
    CrossrefPubMedGoogle Scholar
  • 20 Singh-Manoux A, Kivimaki M, Glymour MM et al. Timing of onset of cognitive decline: results from Whitehall II prospective cohort study. BMJ 2012; 344: d7622
    CrossrefPubMedGoogle Scholar
  • 21 Almeida OP, Garrido GJ, Beer C et al. Cognitive and brain changes associated with ischaemic heart disease and heart failure. Eur Heart J 2012; 33: 1769-1776
    CrossrefPubMedGoogle Scholar
  • 22 Sun X, Lindsay J, Monsein LH et al. Silent brain injury after cardiac surgery: a review: cognitive dysfunction and magnetic resonance imaging diffusion-weighted imaging findings. JACC 2012; 60: 791-797
    CrossrefPubMedGoogle Scholar
  • 23 Nasreddine ZS, Phillips NA, Bédirian V et al. The Montreal Cognitive Assessment, MoCA: A Brief Screeing Tool For Mild Cognitive Impairment. J Am Geriatr Soc 2005; 53: 695-699
    CrossrefPubMedGoogle Scholar
  • 24 Leistner K, Beyer H-M Hrsg. Rehabilitation in der gesetzlichen Krankenversicherung. Antragsverfahren unter besonderer Berücksichtigung der ICF. Landsberg: ecomed Verlagsgesellschaft; 2005
    Google Scholar
  • 25 Jiang W, Kuchibhatla M, Cuffe MS et al. Prognostic Value of Anxiety and Depression in Patients With Chronic Heart Failure. Circulation 2004; 110: 3452-3456
    CrossrefPubMedGoogle Scholar
  • 26 Tonne C, Schwartz J, Mittleman M et al. Long-Term Survival After Acute Myocardial Infarction Is Lower in More Deprived Neighborhoods. Circulation 2005; 111: 3063-3070
    CrossrefPubMedGoogle Scholar
  • 27 Vanhees L, Geladas N, Hansen D et al. Importance of characteristics and modalities of physical activity and exercise in the management of cardiovascular health in individuals with cardiovascular risk factors: recommendations from the EACPR (Part II). European Journal of Preventive Cardiology 2012; 19: 1006-1033
    PubMedGoogle Scholar
  • 28 Bjarnason-Wehrens B, Schulz O, Halle M et al. Leitlinie körperliche Aktivität zur Sekundärprävention und Therapie kardiovaskulärer Erkrankungen. Clin Res Cardiol Suppl 2009; 4: 1-44
    PubMedGoogle Scholar
  • 29 Rius-Ottenheim N, Geleijnse J, Kromhout D et al. Physical activity after myocardial infarction: is it related to mental health?. European Journal of Preventive Cardiology 2012; 20: 399-408
    PubMedGoogle Scholar
  • 30 Franklin B. Update on secondary prevention of cardiovascular disease and exercise-based cardiac rehabilitation. In: Leon AS. Physical activity and cardiovascular health, a national consensus. Champaign: Human Kinetics; 2001: 151-161
    Google Scholar
  • 31 Iliou MC, Pavy B, Martinez J et al. Exercise training is safe after coronary stenting: a prospective multicentre study. Eur J Prev Cardiol 2013; Sep 20. [Epub ahead of print]
    PubMedGoogle Scholar
  • 32 Urhausen A, Kindermann W. Trainingsempfehlungen im Gesundheitssport und Klassifikation der Sportarten. In: Kindermann W, Dickhuth H-H, Niess A, et al. Sportkardiologie – Körperliche Aktivität bei Herzerkrankungen. Darmstadt: Steinkopff; 2007: 67-88
    Google Scholar
  • 33 Rognmo O, Moholdt T, Bakken H. Cardiovascular risik of high- versus moderate-intensity aerobic exercise in coronary heart disease patients. Circulation 2012; 126: 1436-1440
    CrossrefPubMedGoogle Scholar
  • 34 Brusis OA. Stadien der kardiologischen Rehabilitation. In: Brusis OA, Matlik M, Unverdorben M. Handbuch der Herzgruppenbetreuung. Ballingen: Spitta; 2002. b 25-34
    CrossrefGoogle Scholar
  • 35 Braumann K-M. Bewegung als Therapie. Herzmedizin 2013; 2: 6-11
    PubMedGoogle Scholar
  • 36 Basford JR, Oh JK, Allison TG et al. Safety, acceptance, and physiologic effects of sauna bathing in people with chronic heart failure: a pilot report. Arch Phys Med Rehabil 2009; 90: 173-177
    CrossrefPubMedGoogle Scholar
  • 37 Iwatani N, Saihara K, Hamasaki S et al. Enjoying gardening produces desirable cardiovascular prognosis by maintaining favorable coronary endothelial function. J Am Coll Cardiol 2011; 57: E623-E623
    CrossrefPubMedGoogle Scholar
  • 38 Chen TY, Janke MC. Gardening as a potential activity to reduce falls in older adults. J Aging Phys Act 2012; 20: 15-31
    PubMedGoogle Scholar
  • 39 Zahger D, Leibowitz D, Tabb IK et al. Long-distance air travel soon after an acute coronary syndrome: a prospective evaluation of a triage protocol. Am Heart J 2000; 140: 241-242
    CrossrefPubMedGoogle Scholar
  • 40 Mehta SR, Yusuf S, Peters RJ et al. Effects of pretreatment with clopidogrel and aspirin followed by long-term therapy in patients undergoing percutaneous coronary intervention: the PCI-CURE study. Lancet 2001; 358: 527-533
    CrossrefPubMedGoogle Scholar
  • 41 Yusuf S, Zhao F, Mehta SR et al. Effects of clopidogrel in addition to aspirin in patients with acute coronary syndromes without ST-segment elevation. N Engl J Med 2001; 345: 494-502
    CrossrefPubMedGoogle Scholar
  • 42 Hamm CW, Bassand J-P, Agewall S et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart Journal 2011; 32: 2999-3054
    PubMedGoogle Scholar
  • 43 Zeymer U, Kastrati A, Rassaf T et al. Kommentar zu den Leitlinien der Europäischen Gesellschaft für Kardiologie (ESC) zur Therapie des akuten Herzinfarkts bei Patienten mit ST-Streckenhebung (STEMI). Kardiologe 2013; 7: 410-422
    CrossrefPubMedGoogle Scholar
  • 44 The Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 1994; 344: 1383-1389
    PubMedGoogle Scholar
  • 45 Lardizabal JA, Deedwania P. Lipid-lowering therapy with statins for the primary and secondary prevention of cardiovascular disease. Cardiol Clin 2011; 29: 87-103
    CrossrefPubMedGoogle Scholar
  • 46 AIM-HIGH Investigators. Niacin in patients with low HDL cholesterol levels receiving intensive statin therapy. N Engl J Med 2011; 365: 2255-2267
    CrossrefPubMedGoogle Scholar
  • 47 Stone NJ, Robinson J, Lichtenstein AH et al. ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation 2013; Nov 12. [Epub ahead of print]
    PubMedGoogle Scholar
  • 48 Reibis R, Treszl A, Bestehorn K et al. Comparable short-term prognosis in diabetic and non-diabetic patients with acute coronary syndrome after cardiac rehabilitation. Eur J Prev Cardiol 2012; 19: 15-22
    CrossrefPubMedGoogle Scholar
  • 49 Jorenby DE, Hays JT, Rigotti NA. Varenicline Phase 3 Study Group et al. Efficacy of varenicline, an alpha4beta2 nicotinic acetylcholine receptor partial agonist, vs placebo or sustained-release bupropion for smoking cessation: a randomized controlled trial. JAMA 2006; 296: 56-63
    CrossrefPubMedGoogle Scholar
  • 50 Singh S, Joke YK, Spangler JG et al. Risk of serious adverse cardiovascular events associated with varenicline: a systematic review and meta-analysis. CMAJ 2011; 183: 1359-1366
    CrossrefPubMedGoogle Scholar
  • 51 Thomas KH, Martin RM, Davies NM et al. Smoking cessation treatment and risk of depression, suicide, and self harm in the Clinical Practice Research Datalink: prospective cohort study. BMJ 2013; 347: f5704
    CrossrefPubMedGoogle Scholar
  • 52 Mills EJ, Thorlund K, Eapen S et al. Cardiovascular events associated with smoking cessation pharmacotherapies: a network meta-analysis. Circulation 2014; 129: 28-41
    CrossrefPubMedGoogle Scholar
  • 53 Cahill K, Stevens S, Perera R et al. Pharmacological interventions for smoking cessation: an overview and network meta-analysis. Cochrane Database Syst Rev 2013; 5 CD009329
    PubMedGoogle Scholar
  • 54 Bardy GH, Lee KL, Mark DB et al. Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT) Investigators. Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005; 352: 225-237
    CrossrefPubMedGoogle Scholar
  • 55 Völler H, Kamke W, Klein HU et al. Clinical practice of defibrillator implantation after myocardial infarction: impact of implant time: results from the PreSCD II registry. Europace 2011; 13: 499-508
    CrossrefPubMedGoogle Scholar
  • 56 Dimsdale JE. Psychological stress and cardiovascular disease. J Am Coll Cardiol 2008; 5: 1237-1246
    PubMedGoogle Scholar
  • 57 Stringhini S, Sabia S, Shipley M. Association of socioeconomic position with health behaviors and mortality. JAMA 2010; 303: 1159-1166
    CrossrefPubMedGoogle Scholar
  • 58 Siegrist J, Dragano N. Psychosocial stress and disease risks in occupational life. Results of international studies on the demand-control and the effort-reward imbalance models. Bundesgesundheitsbl Gesundheitsforsch Gesundheitssch 2008; 51: 305-312
    PubMedGoogle Scholar
  • 59 Low CA, Thurston RC, Matthews KA. Psychosocial factors in the development of heart disease in women: current research and future directions. Psychosom Med 2010; 72: 842-854
    CrossrefPubMedGoogle Scholar
  • 60 Nicholson A, Kuper H, Hemingway H. Depression as an aetiologic and prognostic factor in coronary heart disease: a meta-analysis of 6362 events among 146538 participants in 54 observational studies. Eur Heart J 2006; 27: 2763-2774
    Google Scholar
  • 61 Williams JE, Mosley Jr TH, Kop WJ. Vital exhaustion as a risk factor for adverse cardiac events (from the atherosclerosis Risk in Communities [ARIC] study). Am J Cardiol 2010; 105: 1661-1665
    CrossrefPubMedGoogle Scholar
  • 62 Roest AM, Martens EJ, de Jonge P. Anxiety and risk of incident coronary heart disease: a meta-analysis. J Am Coll Cardiol 2010; 56: 38-46
    CrossrefPubMedGoogle Scholar
  • 63 Linden W, Phillips MJ, Leclerc J. Psychological treatment of cardiac patients: a meta-analysis. Eur Heart J 2007; 28: 2972-2984
    Google Scholar
  • 64 Whalley B, Rees K, Davies P. Psychological interventions for coronary heart disease. Cochrane Database of systematic reviews 2011; CD002902
    PubMedGoogle Scholar
  • 65 Hillert A, Müller-Fahrnow W, Radoschewski FM Hrsg. Medizinisch-beruflich orientierte Rehabilitation. Grundlagen und klinische Praxis. Köln: Deutscher Ärzteverlag; 2009
    Google Scholar
  • 66 Streibelt M. Steuerung besonderer beruflicher Problemlagen als Voraussetzung effektiv durchgeführter medizinischer Rehabilitationsleistungen. Praxis Klinische Verhaltensmedizin 2010; 86/1: 5-14
    PubMedGoogle Scholar
  • 67 Löffler S, Wolf HD, Vogel H. Entwicklung des Würzburger Screenings – Ein generisches Instrument zur Identifikation von beruflichen Problemlagen und dem Bedarf an berufsorientierten Rehabilitationsleistungen. 1. Reha-Symposium des Netzwerks Rehabilitationsforschung in Bayern (NRFB) 2006
    PubMedGoogle Scholar
  • 68 Bürger W, Deck R. SIBAR – ein kurzes Screening-Instrument zur Messung des Bedarfs an berufsbezogenen Behandlungsangeboten in der medizinischen Rehabilitation. Die Rehabilitation 2009; 48: 211-221
    Article in Thieme ConnectPubMedGoogle Scholar
  • 69 www.bfs.de/de/bfs/recht/rsh/volltext/1B_Weiteres_Recht/1B_37_2_BGV.pdf
    PubMed
  • 70 Klein HH, Krämer A, Pieske BM et al. Positionspapier Fahreignung bei kardiovaskulären Erkrankungen. Der Kardiologe 2010; 4: 441-473
    CrossrefPubMedGoogle Scholar
  • 71 http://www.fahrerlaubnisrecht.de/Begutachtungsleitlinien/BGLL%203.4.4.htm
    PubMed
  • 72 Hammill BG, Curtis LH, Schulman KA. Relationship between cardiac rehabilitation and long-term risks of death and myocardial infarction among elderly Medicare beneficiaries. Circulation 2010; 121: 63-70
    CrossrefPubMedGoogle Scholar