INTRACARDIAC THROMBOSIS IN CHRONIC HEART FAILURE CHILDREN WITH CARDIOMYOPATHY WITH DILATED PHENOTYPE

Systolic dysfunction and dilatation of the left ventricle in cardiomyopathy patients contribute to the formation of intracardiac thrombosis, especially against the background of hypercoagulation. To determine the predictors of thrombotic complications and the incidence of intracardiac thrombosis in chronic heart failure patients suffered from cardiomyopathy with dilated phenotype there were examined 100 children aged from 1 month to 18 years. In all patients, there was made an assessment of indices of the hemostasis system, molecular genetic examination, including studies of polymorphic markers of hemostasis system genes, as well as folate cycle genes by the method of polymerase chain reaction (real-time). It was established that thrombosis was observed in 11% of children with a 2B-3 stage of heart failure clinic and a functional class (FC) of 3-4, a systolic dysfunction with an ejection fraction below 40% against the background of hypercoagulation of the plasma link of hemostasis. Analysis of genetic markers showed that risk of thrombotic complications to be 5 times higher for carriers of the pathological allele A of the FII gene among chronic heart failure patients suffered from cardiomyopathy with a dilated phenotype. Patients with severe systolic dysfunction have been prescribed prophylactic antithrombotic therapy to achieve an adequate therapeutic range (for anti-Xa factor activity and platelet hypoaggregation).