Louwsma, J. (Jelger) (2019) De ‘gaan staan-test’ als bepaling van cardiovasculaire autonome disfunctie bij AL-amyloïdose: een retrospectieve observationele studie. thesis, Medicine.
Full text available on request.Abstract
Background: AL amyloidosis is a protein folding disorder affecting multiple organs, including the autonomic nervous system in 10-20% of the patients. We investigated the predictive value of cardiovascular autonomic dysfunction for mortality and the development of autonomic function after treatment in AL amyloidosis patients. Materials and Methods: We conducted a retrospective observational study. The ‘active standing’ test was used to assess cardiovascular autonomic function. 42 patients with AL amyloidosis in which ‘active standing’ tests were performed, before treatment was initiated, were included in the survival analysis. 20 patients who underwent tests both before and after treatment, were included in analysis on the development of autonomic function. Primary outcome was time of survival after diagnosis. Secondary outcome was the difference in ‘active standing’ test outcomes before and after treatment. Results: Median survival times for patients with and without autonomic dysfunction were 114 and 112 months respectively (p=0.958). 3/7 patients with a complete hematological response to treatment and abnormal cardiovascular autonomic function before treatment, showed normal responses after treatment. No difference was found in ‘active standing’ test outcomes between the groups before and after treatment (p=0,375). Conclusion: The ‘active standing’ test as a test for autonomic dysfunction does not predict mortality AL-amyloidosis. Recovery of autonomic neuropathy seems possible in ALamyloidosis.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisoren: and Harms, Dr. M.P.M. and Internist and Nienhuis, Dr. H.L.A. and Internist and Afdeling Interne Geneeskunde UMCG |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:59 |
| Last Modified: | 25 Jun 2020 10:59 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/1935 |
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