Browsing by Author "Ozdemir, Ozcan"

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Evaluation of Effects of Intra Aortic Balloon Counterpulsation on Autonomic Nervous System Functions by Heart Rate Variability Analysis
(Wiley, 2007) Ozdemir, Ozcan; Alyan, Omer; Kacmaz, Fehmi; Kaptan, Zekeriya; Ozbakir, Cemal; Geyik, Bilal; Demir, Ahmet Duran
Background: In patients with acute myocardial infarction (AMI), intraaortic balloon counterpulsation (IABC) may improve cardiac performance, decrease the incidence of recurrent ischemia, and improve survival. Although there have been several reports concerning circulatory maintenance with the IABC, response of the autonomic nervous system to these hemodynamic changes is not clear. Heart rate variability (HRV) analysis has been extensively used to evaluate autonomic modulation of sinus node and to identify patients at risk for an increased cardiac mortality. In this study, we evaluated effects of the IABC on autonomic nervous system functions by HRV analysis. Methods: The study group was composed of 32 consecutive patients (13 female, 19 male aged 61.8 +/- 8.8 years) undergoing IABC. Transthoracic echocardiography and 1-hour Holter recordings for HRV analysis in each IAB pumping mode were obtained. Results: The IABC improved left ventricular diastolic and systolic functions as well as caused an increase in SDNN1, PNN50(1), RMSSD1, and HF1 and a decrease in LF1, LF/HF1, mean heart rate, and the number of ventricular extrasystoles. The improvements in HRV parameters were correlated with some hemodynamic changes such as the increase in MAP and CO during counterpulsation. The only independent factors affecting in-hospital mortality were the change in LF/HF1 ratio (Delta LF/HF1) and the change in the number of ventricular extrasystole (Delta VES). The decrease in LF/HF1 >= 4.9 decreased the mortality by 1.7-folds (RR = 0.6, P = 0.04, 95% CI: 0.1-2.3). The decrease in VES >= 27/15 minutes resulted in mortality reduction by 16-folds (RR = 0.06, P = 0.02, 95% CI: 0.01-0.4). Conclusions: As a result, the IABC, especially in 1:1 support, causes an increase in HRV, decrease in sympathetic overactivity, and improvement in sympathovagal balance besides the favorable hemodynamic changes, and these electrophysiologic changes may explain the role of the IABC in the treatment of ventricular arrhythmias.
Predictors of Symptomatic Hemorrhage After Endovascular Treatment for Anterior Circulation Occlusions: Turkish Endovascular Stroke Registry
(Sage Publications inc, 2022) Sengeze, Nihat; Ozdemir, Ozcan; Eren, Alper; Aykac, Ozlem; Gencer, Elif Sarionder; Giray, Semih; Karaibrahimoglu, Adnan
We evaluated the predictive factors of symptomatic intracranial hemorrhage (SICH) in endovascular treatment of stroke. We included 975 ischemic stroke patients with anterior circulation occlusion. Patients that had hemorrhage and an increase of >= 4 points in their National Institutes of Health Stroke Scale (NIHSS) after the treatment were considered as SICH. The mean age of patients was 65.2 +/- 13.1 years and 469 (48.1%) were women. The median NIHSS was 16 (13-18) and Alberta Stroke Program Early CT 9 (8-10). In 420 patients (43.1%), modified Rankin Scale was favorable (0-2) and mortality was observed in 234 (24%) patients at the end of the third month. Patients with high diastolic blood pressure (P<.05) had significantly higher SICH. SICH was significantly higher in those with high NIHSS scores (P<.001), high blood glucose (P<.001), and leukocyte count at admission (P<.05). Diabetes mellitus (DM) (OR 1.90; P<.001), NIHSS (OR 1.07; P<.05), adjuvant intra-arterial thrombolytic therapy (IA-rtPA) (OR, 1.60; P<.05), and puncture-recanalization time (OR 1.01; P<.05) were independent factors of SICH. Higher baseline NIHSS score, longer procedure time, multiple thrombectomy maneuvers, administration of IA-rtPA, and the history of DM are independent predictors of SICH in anterior circulation occlusion.