Thrombotic events seem to be one of the most common and severe complications having a direct impact on the course of the disease in patients with cardiomyopathy.There were examined 94 children with dilated cardiomyopathy (DCMP) phenotype [49 children with dilated cardiomyopathy (DCMP), including 45 patients with non-compaction cardiomyopathy (NCMP) and remodeling in dilated phenotype]. Thromboses were diagnosed in 9 patients, including 7 DCMP and 2 NCMP cases. In 4 DCMP children, the thrombus was localized in the cavity of the left ventricle, one in the left atrium, the right ventricle, and the inferior vena cava. In NCMP children, intracardiac thrombus formation was not determined, one patient was diagnosed with an acute ischemic disorder of the cerebral circulation; in the second one, the thrombus was detected in the superior vena cava. Thrombosis in DCMP patients was detected against a background of a severe systolic dysfunction of the left ventricle (LVEF of below 30%), and in NCMP children with a moderate dysfunction. Also, the greatest prevalence rate of thrombotic complications was noted in Functional Class III and IV heart failure cases. At the same time, there was no established any influence of polymorphic markers G1691A of gene F5, G20210A of gene F2, C677T of MTHFR gene on the prevalence of thrombotic events. The authors believe the formation of thrombi with the severe LV dysfunction in children with cMYP should be taken into account in the determination the tactics of the treatment of such patients, as it is necessary to make a decision about administering antithrombotic therapy.

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).