Abstract
The research aim is to study the associations of changes in the content of hemoglobin complexes by the Raman spectroscopy with electrical and viscoelastic parameters of erythrocytes (using the dielectrophoresis method) among patients with arterial hypertension (AH) (including resistant AH), to evaluate the possibility of using these parameters for diagnostic purposes. Fifty males (54 ± 6 years) with stage 2 of AH have been examined, 24 of them have showed resistant AH. We have determined a significant decrease in the level of hemoglobin-ligand complexes, Hb-NO (II) complexes in patients with resistant AH compared to those among patients with controlled AH and among healthy patients (p < 0.001 – 0.05). We have found correlations between intensities of the most important signals of hemoglobin Raman spectra (1325, 1350, 1550, 1580, 1660, 1668 cm –1 ) and electric and viscoelastic parameters of erythrocytes (amplitude of erythrocytes deformation, summarized indicators of viscosity and rigidity, the magnitude of the dipole moment, polarizability at the frequency 106 Hz, electrical conductivity, index of destruction), the intensity of which had been the biggest one for resistant AH. It has been shown that the combined use of two methods (Raman spectroscopy of hemoglobin and electrical and the studies of erythrocytes by the dielectrophoresis method) allowed to increase the diagnostic accuracy to detect the resistant arterial hypertension up to 88%, sensitivity up to 84.6%, specificity up to 91.7% compared to the data of the combined clinical and instrumental methods of research. The capability of this combination approach exceeds the capabilities of the methods separately.
Highlights
The literature suggests that the ratio of Raman spectrum peaks I1355 / I1564 indicates the ability of deoxyhemoglobin (d-Hb) to bind O2 and NO; the complex with nitrogen oxide without breaking the connection between the protein and hemoporphyrin was estimated by the ratio of peaks I1626 / I1580
The hemoglobin complex with nitrogen oxide (Hb-NO) regulates the ability of hemoglobin to release the oxygen when the bond between protein and hemoporphyrin was broken, that is measured by the ratio of Raman peaks I1680 / I1580
We have determined a significant decrease in the level of hemoglobin-ligand complexes, Hb-NO (II) complexes in patients with resistant arterial hypertension (RAH) compared to those among patients with controlled arterial hypertension (AH) and among healthy patients (p < 0.001–0.05), that probably reflects the reduced reserves of erythrocytic NO and a decrease in O2 release
Summary
Diagnostic issues and therapeutic tactics for patients with resistant arterial hypertension (RAH) are very relevant due to its high prevalence (it ranges 3 to 24% among patients receiving antihypertensive therapy [1, 2]), an ambiguity of the mechanisms of refractoriness appearance [3], the role of various factors, such as. One of the possible pathogenetic factors influencing the development of RAH is a violation of the bioavailability of nitrogen oxide (NO) produced by erythrocytes [5]. The role of erythrocytes as a participant of the vasoregulation is connected with both a direct “liberation” of NO and stimulation of nitrogen oxide liberation by the endothelium through ATP synthesis by involving erythrocytes. The ATP release from erythrocytes occurs in response to their mechanical deformation: declining plasticity of erythrocytes leads to a decrease in ATP levels, and, to a decrease in the NO synthesis. The aspect of the interplay between erythrocytes and NO for patients with RAH is very promising in terms of existing possibilities to intervene in NO metabolism [7,8,9]
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