ACTIVITY OF NITRO-OXIDATIVE PROCESSES IN PREGNANT WOMEN WITH IDIOPATHIC ARTERIAL HYPOTENSION

Abstract

Primary violation of vascular tone and reactivity is considered the main hemodynamic link in the pathogenesis of idiopathic arterial hypotension (IAH). Two gaseous messengers - nitric oxide (NO) and hydrogen sulfide (H2S) play an important role in the regulation of vascular tone. The research aims at determining the state of the NO system and the level of H2S in women with IAH and their effect on the uteroplacental blood flow. Material and Methods. A number of 20 pregnant women with IAH at 40-41 weeks of gestation were examined (group I); the second group included 20 pregnant women with normotony at 39-40 weeks of gestation. The concentration of the complex of nitrates and nitrites was determined by the reaction of formation of a colored complex by Griss reagent. The content and production of peroxynitrite in alkali and alkaline earth metals were determined according to the procedure described by Vanuffelen et al. Detection of hydrogen sulfide content in blood plasma was performed by the method of Dombkowski et al. Studies of uteroplacental blood flow were performed on ultrasonic diagnostic device "SA-8000 EX" using color Doppler mapping and pulse mapping dopplerometry of the blood flow in the uterine arteries (UA). The assessment of blood flow velocity curves was carried out by determining the pulsation index (PI) in both arteries taking into account the average value. Results. The results of the study showed that an average level of nitrites and nitrates in pregnant women with IAH was 37.0% higher than in women with normotension, and peroxynitrite values were 2.4 times higher, respectively. In contrast, the concentration of H2S in pregnant women with IAH was almost 1.4 times lower, than in pregnant women with normal blood pressure. Doppler study of blood flow indices in UA showed a moderate increase in PI in 28.0% of pregnant women with IAH. Thus, indices of vascular resistance in UA of pregnant women with IAH were higher, on average, by 19.0% than in pregnant women with normotension. Conclusions. High levels of nitrites and nitrates in pregnant women with IAH form the basis for the development of nitrosatous stress, which is accompanied by increasing concentration of highly toxic peroxynitrite. Significant increase in peroxynitrite is one of the causes of endothelial dysfunction. In pregnant women with IAH due to the low content of H2S - its vasoconstrictive effects are prevalent, which may indicate an indirect interaction between both of these systems of vasoregulation.

Keywords

• pregnancy
• idiopathic arterial hypotension
• nitric oxide
• hydrogen sulfide
• peroxynitrite
• dopplerometry