cardioКардиологияKardiologiia0022-90402412-5660Kardiomag10.18087/cardio.2019.1.10219cardio-436Research ArticleПРАКТИЧЕСКАЯ КАРДИОЛОГИЯ ПРИЛОЖЕНИЕ ДЛЯ ПРАКТИЧЕСКИХ ВРАЧЕЙ. КЛИНИЧЕСКИЕ СЕМИНАРЫPRACTICAL CARDIOLOGY SUPPLEMENT FOR PRACTISING PHYSICIANS. CLINICAL SEMINARSСовременные тенденции и возможности оказания паллиативной медицинской помощи при хронической сердечной недостаточностиCurrent Trends and Possibilities of Providing Medical Palliative Care in Chronic Heart FailureЛаринаВ. Н.LarinaV. N.

Москва

Larina Vera N. – MD, professor

Moscow

larinav@mail.ruЧукаеваИ. И.ChukaevaI. I.

Москва

Moscow

ЛаринВ. Г.LarinV. G.

Москва

Moscow

ФГБОУ ВО «Российский национальный исследовательский медицинский университет им. Н. И. Пирогова» Минздрава РоссииРоссияPirogov Russian National Research Medical UniversityRussian Federation2019280120195918492Copyright © Kardiomag, 20192019KardiomagKardiomaghttps://cardio.elpub.ru/jour/about/submissions#copyrightNoticehttps://cardio.elpub.ru/jour/article/view/436

Хроническая сердечная недостаточность (ХСН) представляет собой важнейшую проблему здравоохранения из-за высокой распространенности и летальности. Не поддающиеся лечению симптомы на терминальной стадии заболевания, потребность в общении и поддержке близкого окружения объединяют больных с ХСН и онкологическими заболеваниями, но, несмотря на это, крайне редко пациенты с ХСН получают специализированную паллиативную медицинскую помощь (ПМП). В обзорной статье рассматриваются необходимость и возможные пути оказания ПМП пациентам с ХСН и их близкому окружению. Обсуждаются варианты течения ХСН в терминальной фазе, понятие «должного ухода» в конце жизни и концепции разных специалистов по оказанию ПМП при данной патологии с учетом предпочтений пациентов.

Chronic heart failure (CHF) is an important healthcare problem because of high prevalence, morbidity and mortality rates. Treatment resistant symptoms, need for communication and support, unite patients with CHF and oncological diseases but despite that CHF patients rarely receive specialized palliative care (SPC). This review is devoted to the need and possible ways of providing SPC to patients with CHF and their families. We discuss here variants of CHF course in terminal phase, the term end of life appropriate care, various specialists’ concepts of SPC delivering to CHF patients in accordance with their preferences.

хроническая сердечная недостаточностьпаллиативная помощьпомощь в конце жизниchronic heart failurepalliative careend-of-life careReferencesWorld Health Organisation. Global Atlas of Palliative Care at the End of Life. World health Organisation 2014.World Health Organisation. Global Atlas of Palliative Care at the End of Life. World health Organisation 2014.Murray S., Sheikh A. Palliative care beyond cancer: care for all at the end of life. BMJ 2008;336:958–959. DOI: 10.1136/bmj.39535.491238.94Murray S., Sheikh A. Palliative care beyond cancer: care for all at the end of life. BMJ 2008;336:958–959. DOI: 10.1136/bmj.39535.491238.94Worldwide palliative care alliance (WPCA); World Health Organization 2015. http://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdg; World Health Organisation. Global Atlas of Palliative Care at the End of Life. World health Organisation 2014Worldwide palliative care alliance (WPCA); World Health Organization 2015. http://www.who.int/nmh/Global_Atlas_of_Palliative_Care.pdg; World Health Organisation. Global Atlas of Palliative Care at the End of Life. World health Organisation 2014Palliative care by the adult and to children: organization and vocational education. Collection of documents of WHO and EAPP. M.: R. Valent 2014;180 p. Russian (Паллиативная помощь взрослым и детям: организация и профессиональное обучение. Сборник документов ВОЗ и ЕАПП. М.: Р. Валент 2014;180 с.).Palliative care by the adult and to children: organization and vocational education. Collection of documents of WHO and EAPP. M.: R. Valent 2014;180 p. Russian (Паллиативная помощь взрослым и детям: организация и профессиональное обучение. Сборник документов ВОЗ и ЕАПП. М.: Р. Валент 2014;180 с.).Gamondi C., Larkin P., Payne S. Core competencies in palliative care: an EAPC White Paper on palliative care education. Eur J Palliative Care 2013;20(2):86–89.Gamondi C., Larkin P., Payne S. Core competencies in palliative care: an EAPC White Paper on palliative care education. Eur J Palliative Care 2013;20(2):86–89.Nordgren L., Olsson H. Palliative care in a coronary care unit: a qualitative study of physicians’ and nurses’ perceptions. J Clin Nurs 2004;13(2):185–193. DOI: 10.1111/j.1365-2702.2004.00816.xNordgren L., Olsson H. Palliative care in a coronary care unit: a qualitative study of physicians’ and nurses’ perceptions. J Clin Nurs 2004;13(2):185–193. DOI: 10.1111/j.1365-2702.2004.00816.xNaghavi M., Wang H., Lozano R. et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990—2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117– 171. DOI: 10.1016/S0140-6736(14)61682-2.Naghavi M., Wang H., Lozano R. et al. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990—2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet 2015;385:117– 171. DOI: 10.1016/S0140-6736(14)61682-2.Townsend N., Wilson L., Bhatnagar P. et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016;37:3232–3245. DOI: 10.1093/eurheartj/ehw334Townsend N., Wilson L., Bhatnagar P. et al. Cardiovascular disease in Europe: epidemiological update 2016. Eur Heart J 2016;37:3232–3245. DOI: 10.1093/eurheartj/ehw334Komajda M., Cowie M., Tavazzi L. et al. on behalf of the QUALIFY Investigators. Physicians’ guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Failure 2017;19(11):1414–1423; DOI:10.1002/ejhf.887Komajda M., Cowie M., Tavazzi L. et al. on behalf of the QUALIFY Investigators. Physicians’ guideline adherence is associated with better prognosis in outpatients with heart failure with reduced ejection fraction: the QUALIFY international registry. Eur J Heart Failure 2017;19(11):1414–1423; DOI:10.1002/ejhf.887Pazos-López P., Peteiro-Vázquez J., Carcía-Campos A. et al. The causes, consequences, and treatment of left or right heart failure. Vascular Health and Risk Management 2011;7:237–254. DOI: 10.2147/VHRM.S10669Pazos-López P., Peteiro-Vázquez J., Carcía-Campos A. et al. The causes, consequences, and treatment of left or right heart failure. Vascular Health and Risk Management 2011;7:237–254. DOI: 10.2147/VHRM.S10669Mareev V. Yu., Fomin I. V., Ageev F. T. et al. Clinical recommendations. Chronic Heart Failure (CHF). Heart Failure 2017;18(1):3– 40. Russian (Мареев В. Ю., Фомин И.В., Агеев Ф.Т. и др. Клинические рекомендации. Хроническая сердечная недостаточность (ХСН). Журнал Сердечная Недостаточность 2017;18(1):3–40).Mareev V. Yu., Fomin I. V., Ageev F. T. et al. Clinical recommendations. Chronic Heart Failure (CHF). Heart Failure 2017;18(1):3– 40. Russian (Мареев В. Ю., Фомин И.В., Агеев Ф.Т. и др. Клинические рекомендации. Хроническая сердечная недостаточность (ХСН). Журнал Сердечная Недостаточность 2017;18(1):3–40).Polyakov D. S., Fomin I. V., Valikulova F. Yu. et al. EPOHA-HSN epidemiological program: a decompensation of chronic heart failure in real clinical practice (EPOHA-D-HSN). Heart failure 2016;17(5):299–305. DOI: 10.18087/rhfj.2016.5.2239. Russian (Поляков Д. С., Фомин И. В., Валикулова Ф. Ю. и др. Эпидемиологическая программа ЭПОХА–ХСН: декомпенсация хронической сердечной недостаточности в реальной клинической практике (ЭПОХА–Д–ХСН). Журнал Сердечная Недостаточность 2016;17(5):299–305. DOI: 10.18087/rhfj.2016.5.2239).Polyakov D. S., Fomin I. V., Valikulova F. Yu. et al. EPOHA-HSN epidemiological program: a decompensation of chronic heart failure in real clinical practice (EPOHA-D-HSN). Heart failure 2016;17(5):299–305. DOI: 10.18087/rhfj.2016.5.2239. Russian (Поляков Д. С., Фомин И. В., Валикулова Ф. Ю. и др. Эпидемиологическая программа ЭПОХА–ХСН: декомпенсация хронической сердечной недостаточности в реальной клинической практике (ЭПОХА–Д–ХСН). Журнал Сердечная Недостаточность 2016;17(5):299–305. DOI: 10.18087/rhfj.2016.5.2239).Bekelman D., Hutt E., Masoudi F. et al. Defining the role of palliative care in older adults with heart failure. Int J Cardiol 2008;125:183– 190.DOI: 10.1016/j.ijcard.2007.10.005Bekelman D., Hutt E., Masoudi F. et al. Defining the role of palliative care in older adults with heart failure. Int J Cardiol 2008;125:183– 190.DOI: 10.1016/j.ijcard.2007.10.005Adler E., Goldfinger J., Kalman J. et al. Palliative care in the treatment of advanced heart failure. Circulation 2009;120:2597–606. DOI: 10.1161/CIRCULATIONAHA.109.869123Adler E., Goldfinger J., Kalman J. et al. Palliative care in the treatment of advanced heart failure. Circulation 2009;120:2597–606. DOI: 10.1161/CIRCULATIONAHA.109.869123Blinderman C., Homel P., Billings A. et al. Symptom distress and quality of life in patients with advanced congestive heart failure. J Pain Symptom Manage 2008;35:594–603. DOI: 10.1016/j.jpainsymman.2007.06.007Blinderman C., Homel P., Billings A. et al. Symptom distress and quality of life in patients with advanced congestive heart failure. J Pain Symptom Manage 2008;35:594–603. DOI: 10.1016/j.jpainsymman.2007.06.007National Institutes of Health. National institutes of health stateof-the science conference statement of improving end-of-life care, 2004. Online source. http://consensus.nih.gov/2004/2004EndOfLifeCareSOS024html.htm. Accessed 28 Aug 2017.National Institutes of Health. National institutes of health stateof-the science conference statement of improving end-of-life care, 2004. Online source. http://consensus.nih.gov/2004/2004EndOfLifeCareSOS024html.htm. Accessed 28 Aug 2017.Ward C. The need for palliative care in the management of heart failure. Heart 2002;87:294–298.Ward C. The need for palliative care in the management of heart failure. Heart 2002;87:294–298.Riley J., Beattie J. Palliative care in heart failure: facts and numbers. ESC Heart Failure 2017;4:81–87. DOI: 10.1002/ehf2.12125Riley J., Beattie J. Palliative care in heart failure: facts and numbers. ESC Heart Failure 2017;4:81–87. DOI: 10.1002/ehf2.12125Goodlin S., Wingate S., Albert N. et al. PAIN-HF Investigators. Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study. J Card Fail 2012;18(10):776–783. DOI: 10.1016/j.cardfail.2012.07.007Goodlin S., Wingate S., Albert N. et al. PAIN-HF Investigators. Investigating pain in heart failure patients: the pain assessment, incidence, and nature in heart failure (PAIN-HF) study. J Card Fail 2012;18(10):776–783. DOI: 10.1016/j.cardfail.2012.07.007Smith O., Michielsen H., Pelle A. et al. Symptoms of fatigue in chronic heart failure patients: Clinical and psychological predictors. Eur J of Heart Fail 2007;9:922–927. DOI: 10.1016/j.ejheart.2007.05.016Smith O., Michielsen H., Pelle A. et al. Symptoms of fatigue in chronic heart failure patients: Clinical and psychological predictors. Eur J of Heart Fail 2007;9:922–927. DOI: 10.1016/j.ejheart.2007.05.016Jiang W., Kuchibhatla M., Clary G. et al. Relationship between depressive symptoms and long-term mortality in patients with heart failure. Am Heart J 2007;154:102–108. DOI: 10.1016/j.ahj.2007.03.043Jiang W., Kuchibhatla M., Clary G. et al. Relationship between depressive symptoms and long-term mortality in patients with heart failure. Am Heart J 2007;154:102–108. DOI: 10.1016/j.ahj.2007.03.043Boyd K., Murray S., Kendall M. et al. Living with advanced heart failure: a prospective, community based study of patients and their carers. Eur J Heart Fail 2004;6(5):585–591. DOI: 10.1016/j.ejheart.2003.11.018Boyd K., Murray S., Kendall M. et al. Living with advanced heart failure: a prospective, community based study of patients and their carers. Eur J Heart Fail 2004;6(5):585–591. DOI: 10.1016/j.ejheart.2003.11.018Gordon N., O’Riordan D., Dracup K. et al. Let Us Talk About It: Heart Failure Patients’ Preferences Toward Discussions about Prognosis, Advance Care Planning, and Spiritual Support. J Palliative Medicine 2017;1(20):79–83. DOI: 10.1089/jpm.2016.0097Gordon N., O’Riordan D., Dracup K. et al. Let Us Talk About It: Heart Failure Patients’ Preferences Toward Discussions about Prognosis, Advance Care Planning, and Spiritual Support. J Palliative Medicine 2017;1(20):79–83. DOI: 10.1089/jpm.2016.0097Lunney J., Lynn J., Foley D. et al. Patterns of functional decline at the end of life. JAMA 2003;289(18):2387–2392. DOI: 10.1001/jama.289.18.2387Lunney J., Lynn J., Foley D. et al. Patterns of functional decline at the end of life. JAMA 2003;289(18):2387–2392. DOI: 10.1001/jama.289.18.2387Koelling T., Joseph S., Aaronson K. Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving beta-blockers. J Heart Lung Transplant 2004;23:1414– 1422. DOI: 10.1016/j.healun.2003.10.002Koelling T., Joseph S., Aaronson K. Heart failure survival score continues to predict clinical outcomes in patients with heart failure receiving beta-blockers. J Heart Lung Transplant 2004;23:1414– 1422. DOI: 10.1016/j.healun.2003.10.002Levy W., Mozaffarian D., Linker D. et al. The Seattle Heart Failure Model: prediction of svival in heart failure. Circulation 2006;113:1424–1433. DOI: 10.1161/CIRCULATIONAHA.105.584102Levy W., Mozaffarian D., Linker D. et al. The Seattle Heart Failure Model: prediction of svival in heart failure. Circulation 2006;113:1424–1433. DOI: 10.1161/CIRCULATIONAHA.105.584102Jaarsma T., Beattie J., Ryder M. et al. Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2009;1 (5):433–443. DOI: 10.1093/eurjhf/hfp041Jaarsma T., Beattie J., Ryder M. et al. Palliative care in heart failure: a position statement from the palliative care workshop of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 2009;1 (5):433–443. DOI: 10.1093/eurjhf/hfp041Ponikowski P., Voors A., Anker S. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;69:1167. DOI:10.1093/eurheartj/ehw128Ponikowski P., Voors A., Anker S. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur Heart J 2016;69:1167. DOI:10.1093/eurheartj/ehw128Howlett J., Morrin L., Fortin M. et al. End-of-life planning in heart failure: It should be the end of the beginning. The Canadian Journal of Cardiology 2010;26(3):135–141.Howlett J., Morrin L., Fortin M. et al. End-of-life planning in heart failure: It should be the end of the beginning. The Canadian Journal of Cardiology 2010;26(3):135–141.Denvir M., Highet G., Robertson S. et al. Future Care Planning for patients approaching end-of-life with advanced heart disease: an interview study with patients, carers and healthcare professionals exploring the content, rationale and design of a randomised clinical trial. BMJ Open 2014;4(7):e005021. DOI: 10.1136/bmjopen-2014-005021Denvir M., Highet G., Robertson S. et al. Future Care Planning for patients approaching end-of-life with advanced heart disease: an interview study with patients, carers and healthcare professionals exploring the content, rationale and design of a randomised clinical trial. BMJ Open 2014;4(7):e005021. DOI: 10.1136/bmjopen-2014-005021Westlake C., Smith V. Nursing concerns with palliative care and at the end-of-life in patients with heart failure. Nursing: Research and Reviews 2015;5:33–47. https://doi.org/10.2147/NRR.S45298Westlake C., Smith V. Nursing concerns with palliative care and at the end-of-life in patients with heart failure. Nursing: Research and Reviews 2015;5:33–47. https://doi.org/10.2147/NRR.S45298Willems D., Hak A., Visser F., Van der Wal G. Thoughts of patients with advanced heart failure on dying. Palliat Med 2004;18:564– 572. doi.org/10.1191/0269216304pm919oaWillems D., Hak A., Visser F., Van der Wal G. Thoughts of patients with advanced heart failure on dying. Palliat Med 2004;18:564– 572. doi.org/10.1191/0269216304pm919oaBolt E., Pasman R., Willems D., Onwuteaka-Philipsen B. Appropriate and inappropriate care in the last phase of life: an explorative study among patients and relatives. BMC Health Services Research 2016;16(1):655. DOI: 10.1186/s12913-016-1879-3Bolt E., Pasman R., Willems D., Onwuteaka-Philipsen B. Appropriate and inappropriate care in the last phase of life: an explorative study among patients and relatives. BMC Health Services Research 2016;16(1):655. DOI: 10.1186/s12913-016-1879-3Yancy C., Jessup M., Bozkurt B. et al. American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2013;62:e147–239. DOI: 10.1016/j.jacc.2013.05.019Yancy C., Jessup M., Bozkurt B. et al. American College of Cardiology Foundation; American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. J Am Coll Cardiol 2013;62:e147–239. DOI: 10.1016/j.jacc.2013.05.019Course of lectures on palliative medicine. Under G.A. Novikov’s edition. Moscow 2017;368–384. Russian (Курс лекций по паллиативной медицине. Под ред. Г. А. Новикова. М., 2017;368–384).Course of lectures on palliative medicine. Under G.A. Novikov’s edition. Moscow 2017;368–384. Russian (Курс лекций по паллиативной медицине. Под ред. Г. А. Новикова. М., 2017;368–384).Bekelman D., Allen L., McBrude C. et al. Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure The CASA Randomized Clinical Trial. JAMA Intern Med. Published online February 26, 2018. doi:10.1001/jamainternmed.2017.8667Bekelman D., Allen L., McBrude C. et al. Effect of a Collaborative Care Intervention vs Usual Care on Health Status of Patients With Chronic Heart Failure The CASA Randomized Clinical Trial. JAMA Intern Med. Published online February 26, 2018. doi:10.1001/jamainternmed.2017.8667Zhou K., Mao Y. Palliative care in heart failure : A meta-analysis of randomized controlled trials. Herz 2018 Feb 21. DOI: 10.1007/s00059-017-4677-8.Zhou K., Mao Y. Palliative care in heart failure : A meta-analysis of randomized controlled trials. Herz 2018 Feb 21. DOI: 10.1007/s00059-017-4677-8.Rogers J., Patel C., Mentz R. et al. Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial. J Am Coll Cardiol 2017;70(3):342–343. DOI.org/10.1016/j.jacc.2017.05.030Rogers J., Patel C., Mentz R. et al. Palliative Care in Heart Failure: The PAL-HF Randomized, Controlled Clinical Trial. J Am Coll Cardiol 2017;70(3):342–343. DOI.org/10.1016/j.jacc.2017.05.030Adler E., Wettersten N. Mending the soul when the heart is broken. J Am Coll Cardiol 2017;70(3):342–343. DOI: 10.1016/j.jacc.2017.05.058Adler E., Wettersten N. Mending the soul when the heart is broken. J Am Coll Cardiol 2017;70(3):342–343. DOI: 10.1016/j.jacc.2017.05.058Chow J., Senderodich H. It’s Time to Talk: Challenges in Providing Integrated Palliative Care in Advanced Congestive Heart Failure. Curr Cardiol Rev 2018. Jan 23. doi: 10.2174/1573403X14666180123165203.Chow J., Senderodich H. It’s Time to Talk: Challenges in Providing Integrated Palliative Care in Advanced Congestive Heart Failure. Curr Cardiol Rev 2018. Jan 23. doi: 10.2174/1573403X14666180123165203.The order of the Ministry of Health of the Russian Federation of April 14, 2015 No. 187n “About the statement of the Order of rendering palliative medical care to adult population”. Russian (Приказ Министерства здравоохранения Российской Федерации от 14 апреля 2015 г. № 187н “Об утверждении Порядка оказания паллиативной медицинской помощи взрослому населению”). https://www.rosminzdrav.ru/documents/9139-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-14-aprelya-2015-g-187n-ob-utverzhdenii-poryadka-okazaniya-palliativnoy-meditsinskoy-pomoschi-vzroslomu-naseleniyuThe order of the Ministry of Health of the Russian Federation of April 14, 2015 No. 187n “About the statement of the Order of rendering palliative medical care to adult population”. Russian (Приказ Министерства здравоохранения Российской Федерации от 14 апреля 2015 г. № 187н “Об утверждении Порядка оказания паллиативной медицинской помощи взрослому населению”). https://www.rosminzdrav.ru/documents/9139-prikaz-ministerstva-zdravoohraneniya-rossiyskoy-federatsii-ot-14-aprelya-2015-g-187n-ob-utverzhdenii-poryadka-okazaniya-palliativnoy-meditsinskoy-pomoschi-vzroslomu-naseleniyuThe order of the Moscow Department of Healthcare of August 28 2017 N 605 “About the organization of rendering palliative medical care to adult population”. Russian (Приказ Департамента здравоохранения г. Москвы от 28 августа 2017 N 605 «Об организации оказания паллиативной медицинской помощи взрослому населению»). https://www.mos.ru/upload/documents/files/4258/605.pdfThe order of the Moscow Department of Healthcare of August 28 2017 N 605 “About the organization of rendering palliative medical care to adult population”. Russian (Приказ Департамента здравоохранения г. Москвы от 28 августа 2017 N 605 «Об организации оказания паллиативной медицинской помощи взрослому населению»). https://www.mos.ru/upload/documents/files/4258/605.pdfNovikov G.A., Sharafutdinov M.G., Rudoy S.V. et al. The prospects of development and integration of educational programs for palliative medical care in the Russian Federation. M.: “Palliative Medicine and Rehabilitation of Patients” Fund / Palliative medicine and rehabilitation 2014;2:5–8. Russian (Новиков Г.А., Шарафутдинов М.Г., Рудой С.В. и др. Перспективы развития и интеграция образовательных программ по паллиативной медицинской помощи в Российской Федерации. М.: Фонд «Паллиативная медицина и реабилитация больных»/ Паллиативная медицина и реабилитация 2014;2:5–8).Novikov G.A., Sharafutdinov M.G., Rudoy S.V. et al. The prospects of development and integration of educational programs for palliative medical care in the Russian Federation. M.: “Palliative Medicine and Rehabilitation of Patients” Fund / Palliative medicine and rehabilitation 2014;2:5–8. Russian (Новиков Г.А., Шарафутдинов М.Г., Рудой С.В. и др. Перспективы развития и интеграция образовательных программ по паллиативной медицинской помощи в Российской Федерации. М.: Фонд «Паллиативная медицина и реабилитация больных»/ Паллиативная медицина и реабилитация 2014;2:5–8).Nesterenko O.I., Adasheva T.V., Novikov G.A., Zadionchenko V.S. Palliative medical care in cardiology – the myth or reality? Palliative medicine and rehabilitation of 2016;2:5–108. Russian (Нестеренко О.И., Адашева Т.В., Новиков Г.А., Задионченко В.С. Паллиативная медицинская помощь в кардиологии – миф или реальность? Паллиативная медицина и реабилитация 2016;2:5– 10). https://elibrary.ru/item.asp?id=26193742Nesterenko O.I., Adasheva T.V., Novikov G.A., Zadionchenko V.S. Palliative medical care in cardiology – the myth or reality? Palliative medicine and rehabilitation of 2016;2:5–108. Russian (Нестеренко О.И., Адашева Т.В., Новиков Г.А., Задионченко В.С. Паллиативная медицинская помощь в кардиологии – миф или реальность? Паллиативная медицина и реабилитация 2016;2:5– 10). https://elibrary.ru/item.asp?id=26193742Kostenko V. A., Sitnikova M.Yu., Skorodumova E.A. et al. A new scale of assessment of the two-year forecast of survival for the patients hospitalized in a versatile hospital concerning sharp dekompensirovanny heart failure. Cardiology 2017;57(6):33–39. DOI: 10.18565/cardio.2017.6.33–39. Russian (Костенко В.А., Ситникова М.Ю., Скородумова Е.А. и др. Новая шкала оценки двухлетнего прогноза выживаемости для пациентов, госпитализированных в многопрофильный стационар по поводу острой декомпенсированной сердечной недостаточности. Кардиология 2017;57(6):33–39. DOI: 10.18565/сardio.2017.6.33-39).Kostenko V. A., Sitnikova M.Yu., Skorodumova E.A. et al. A new scale of assessment of the two-year forecast of survival for the patients hospitalized in a versatile hospital concerning sharp dekompensirovanny heart failure. Cardiology 2017;57(6):33–39. DOI: 10.18565/cardio.2017.6.33–39. Russian (Костенко В.А., Ситникова М.Ю., Скородумова Е.А. и др. Новая шкала оценки двухлетнего прогноза выживаемости для пациентов, госпитализированных в многопрофильный стационар по поводу острой декомпенсированной сердечной недостаточности. Кардиология 2017;57(6):33–39. DOI: 10.18565/сardio.2017.6.33-39).Sitnikova M.Yu., Bortsova M.A., Galenko V.L. et al. Continuum stages for improvement of the forecast in different subgroups of sick HSN: from the organization of management and optimization of the program of physical rehabilitation to specification of risk factors, available to a research. Transmitting medicine 2015;2(5):62– 72. Russian (Ситникова М.Ю., Борцова М.А., Галенко В.Л. и др. Этапы континуума для улучшения прогноза в разных подгруппах больных ХСН: от организации менеджмента и оптимизации программы физической реабилитации к уточнению доступных для исследования факторов риска. Трансляционная медицина 2015;2(5):62–72).Sitnikova M.Yu., Bortsova M.A., Galenko V.L. et al. Continuum stages for improvement of the forecast in different subgroups of sick HSN: from the organization of management and optimization of the program of physical rehabilitation to specification of risk factors, available to a research. Transmitting medicine 2015;2(5):62– 72. Russian (Ситникова М.Ю., Борцова М.А., Галенко В.Л. и др. Этапы континуума для улучшения прогноза в разных подгруппах больных ХСН: от организации менеджмента и оптимизации программы физической реабилитации к уточнению доступных для исследования факторов риска. Трансляционная медицина 2015;2(5):62–72).

The authors declare that there are no conflicts of interest present.