Barth Juliane, Dewald Oliver, Ewert Peter, Freiberger Annika, Freilinger Sebastian, Gampert Tobias, Harig Frank, Hörer Jürgen, Holdenrieder Stefan, Huntgeburth Michael, Kaemmerer-Suleiman Ann-Sophie, Kohls Niko, Nagdyman Nicole, Neidenbach Rhoia, Schmiedeberg Wolfgang, Suleiman Mathieu N, von Scheidt Fabian, Koch Detlef, Wagener Wolfgang, Mentzner Dirk, Kaemmerer Harald, Mellert Fritz
Department of Cardiac Surgery, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Department of Congenital Heart Disease and Pediatric Cardiology, German Heart Centre Munich, TUM University Hospital, Munich, Germany.
Cardiovasc Diagn Ther. 2025 Jun 30;15(3):684-695. doi: 10.21037/cdt-2024-691. Epub 2025 Jun 26.
Congenital heart defects (CHD) are the most common inborn cardiac anomalies, with approximately 1.35 million children born each year worldwide. Advances in medical treatment over recent decades have reduced mortality, yet morbidity remains high. Many patients now survive into adulthood but continue to have chronic heart disease and often develop complications such as heart failure, arrhythmias, pulmonary hypertension, and acquired cardiac and non-cardiac comorbidities, all of which require ongoing specialized care. Additionally, many adults with CHD (ACHD) lead a sedentary lifestyle, are overweight, and experience mental health issues, further affecting their well-being and quality of life. In this context, preventive, prehabilitative, and rehabilitative measures play an important role in reducing cardiovascular risks and enhancing overall quality of life. Preventive strategies aim to improve physical fitness, address health risks early, and support long-term well-being. Prehabilitation involves a structured, multimodal approach designed to strengthen physical and psychological resilience before planned medical interventions, thereby reducing complications and recovery times. Rehabilitation, on the other hand, facilitates recovery after treatment and promotes sustained health improvements over time. The German Pension Insurance provides programs aimed at enhancing physical fitness, promoting mental well-being, and improving quality of life, with a focus on maintaining employability and supporting occupational reintegration. However, available offerings are often not tailored to the specific needs of the heterogenous group of ACHD, limiting their potential effectiveness. The present article highlights the importance of cardiological prevention and prehabilitation in ACHD, focusing on the role of the German Pension Insurance system in helping affected adults remain employed and improve their quality of life. It explores how services can be better adapted to their needs and suggests that tailored programs, interdisciplinary collaboration, and ongoing research are essential for improving long-term outcomes in ACHD.
先天性心脏病（CHD）是最常见的先天性心脏异常，全球每年约有135万儿童出生时患有此病。近几十年来，医学治疗的进步降低了死亡率，但发病率仍然很高。现在许多患者存活至成年，但仍患有慢性心脏病，且常常出现心力衰竭、心律失常、肺动脉高压以及获得性心脏和非心脏合并症等并发症，所有这些都需要持续的专科护理。此外，许多患有先天性心脏病的成年人（ACHD）生活方式久坐不动、超重，并存在心理健康问题，这进一步影响了他们的幸福感和生活质量。在这种背景下，预防、康复前干预和康复措施在降低心血管风险和提高整体生活质量方面发挥着重要作用。预防策略旨在提高身体素质、尽早解决健康风险并支持长期健康。康复前干预采用结构化的多模式方法，旨在在计划的医疗干预之前增强身体和心理的恢复力，从而减少并发症和恢复时间。另一方面，康复则促进治疗后的恢复，并随着时间的推移促进健康状况的持续改善。德国养老保险提供旨在增强身体素质、促进心理健康和提高生活质量的项目，重点是保持就业能力并支持职业重新融入。然而，现有的服务往往没有针对ACHD这一异质性群体的特定需求进行定制，限制了它们的潜在效果。本文强调了心脏病预防和康复前干预在ACHD中的重要性，重点关注德国养老保险系统在帮助受影响的成年人维持就业和提高生活质量方面的作用。它探讨了如何使服务更好地适应他们的需求，并建议定制项目、跨学科合作和持续研究对于改善ACHD的长期结果至关重要。
