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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">zurniimtpe</journal-id><journal-title-group><journal-title xml:lang="ru">Медицина труда и промышленная экология</journal-title><trans-title-group xml:lang="en"><trans-title>Russian Journal of Occupational Health and Industrial Ecology</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">1026-9428</issn><issn pub-type="epub">2618-8945</issn><publisher><publisher-name>FSBSI “Izmerov Research Institute of Occupational Health”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.31089/1026-9428-2025-65-9-602-609</article-id><article-id custom-type="edn" pub-id-type="custom">wzprpj</article-id><article-id custom-type="elpub" pub-id-type="custom">zurniimtpe-3943</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ПРОФПАТОЛОГАМ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>FOR PROFESSIONAL PATHOLOGISTS</subject></subj-group></article-categories><title-group><article-title>Гипертрофическая кардиомиопатия у работающих во вредных условиях труда: аспекты экспертизы профессиональной пригодности</article-title><trans-title-group xml:lang="en"><trans-title>Hypertrophic cardiomyopathy in workers who work in harmful working conditions: aspects of professional aptitude testing</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7087-8140</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Горохова</surname><given-names>Светлана Георгиевна</given-names></name><name name-style="western" xml:lang="en"><surname>Gorokhova</surname><given-names>Svetlana G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Заведующий кафедрой профпатологии и производственной медицины ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, д-р мед. наук, профессор</p><p>e-mail: cafedra2004@mail.ru</p></bio><bio xml:lang="en"><p>Head of the Chair of Occupational Pathology and Industrial Medicine at the Russian Medical Academy of Continuous Professional Education, Dr. of Sci. (Med.), Professor</p><p>e-mail: cafedra2004@mail.ru</p></bio><email xlink:type="simple">cafedra2004@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-8622-5988</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Алпаев</surname><given-names>Дмитрий Васильевич</given-names></name><name name-style="western" xml:lang="en"><surname>Alpaev</surname><given-names>Dmitry V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Доцент кафедры профпатологии и производственной медицины ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования», Минздрава России; заведующий отделением профессиональных и периодических осмотров Университетской клиники ФГБОУ ВО «Российский университет медицины» Минздрава России, канд. мед. наук</p><p>e-mail: dmalp@mail.ru</p></bio><bio xml:lang="en"><p>Associate Professor at the Russian Medical Academy of Continuous Professional Education; Head of the Department of Professional and Periodic Examinations of the University Clinic at the Russian University of Medicine, Cand. of Sci. (Med.)</p><p>e-mail: dmalp@mail.ru</p></bio><email xlink:type="simple">dmalp@mail.ru</email><xref ref-type="aff" rid="aff-2"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-1011-8323</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Корчагин</surname><given-names>Иван Андреевич</given-names></name><name name-style="western" xml:lang="en"><surname>Korchagin</surname><given-names>Ivan A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Врач отделения профессиональных и предварительных осмотров ФГБОУ ВО «Российский университет медицины» Минздрава России</p><p>e-mail: iakorchagin@mail.ru</p></bio><bio xml:lang="en"><p>Preliminary Examinations Russian University of Medicine of the Ministry of Health of Russia</p><p>e-mail: iakorchagin@mail.ru</p></bio><xref ref-type="aff" rid="aff-3"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-2291-6453</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Стрижаков</surname><given-names>Леонид Александрович</given-names></name><name name-style="western" xml:lang="en"><surname>Strizhakov</surname><given-names>Leonid A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Заместитель директора ФГБНУ «Научно-исследовательский институт медицины труда имени академика Н.Ф. Измерова», профессор кафедры внутренних болезней ФФМ Московского государственного университета им. М.В. Ломоносова; профессор кафедры медицины труда, авиационной, космической и водолазной медицины ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский университет), д-р мед. наук, профессор</p><p>e-mail: strizhakov76@mail.ru</p></bio><bio xml:lang="en"><p>Deputy Director, Izmerov Research Institute of Occupational Health; Professor of the Department of Internal Diseases of the Moscow State University named after M.V. Lomonosov; Professor of the Department of Occupational Medicine, Aviation, Space and Diving Medicine, Sechenov University, Dr. of Sci. (Med.)</p><p>e-mail: strizhakov76@mail.ru</p></bio><email xlink:type="simple">strizhakov76@mail.ru</email><xref ref-type="aff" rid="aff-4"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5211-2560</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Атьков</surname><given-names>Олег Юрьевич</given-names></name><name name-style="western" xml:lang="en"><surname>Atkov</surname><given-names>Oleg Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Профессор кафедры профпатологии и производственной медицины, Российская медицинская академия непрерывного профессионального образования Минздрава России, д-р мед. наук, профессор, академик РАН</p><p>e-mail: AtkovOYU@rmapo.ru</p></bio><bio xml:lang="en"><p>Russian Medical Academy of Continuous Professional Education, Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences</p><p>e-mail: AtkovOYU@rmapo.ru</p></bio><email xlink:type="simple">AtkovOYU@rmapo.ru</email><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, ул. Баррикадная</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Postgraduate Education</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» Минздрава России, ул. Баррикадная; ФГБОУ ВО «Российский университет медицины» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Postgraduate Education; The Russian University of Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-3"><aff xml:lang="ru"><institution>ФГБОУ ВО «Российский университет медицины» Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>The Russian University of Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-4"><aff xml:lang="ru"><institution>ФГБНУ «Научно-исследовательский институт медицины труда имени академика Н.Ф. Измерова»; ФГАОУ ВО «Первый Московский государственный медицинский университет имени И.М. Сеченова» Минздрава России (Сеченовский университет); ФГОУ ВПО «Московский государственный университет имени М.В. Ломоносова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Izmerov Research Institute of Occupational Health; I.M. Sechenov First Moscow State Medical University; Lomonosov Moscow State University, Faculty of Fundamental Medicine</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>30</day><month>10</month><year>2025</year></pub-date><volume>65</volume><issue>9</issue><fpage>602</fpage><lpage>609</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Горохова С.Г., Алпаев Д.В., Корчагин И.А., Стрижаков Л.А., Атьков О.Ю., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Горохова С.Г., Алпаев Д.В., Корчагин И.А., Стрижаков Л.А., Атьков О.Ю.</copyright-holder><copyright-holder xml:lang="en">Gorokhova S.G., Alpaev D.V., Korchagin I.A., Strizhakov L.A., Atkov O.Y.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.journal-irioh.ru/jour/article/view/3943">https://www.journal-irioh.ru/jour/article/view/3943</self-uri><abstract><p>Гипертрофическая кардиомиопатия — заболевание миокарда, ассоциированное с риском внезапной сердечной смерти. Основываясь на клинических рекомендациях и нормативных актах (Приказ Минздрава России № 29н), рассмотрены критерии диагноза и анатомо-морфологические типы, фенокопии гипертрофической кардиомиопатии, алгоритмы обследования и стратификации риска внезапной сердечной смерти, необходимые при решении вопросов профессиональной пригодности. Представлено клиническое наблюдение пациента с гипертрофической кардиомиопатией, направленного на обязательный периодический медицинский осмотр. Анализ показал, что согласно приказу № 29н, диагноз «гипертрофическая кардиомиопатия» сам по себе не служит медицинским противопоказанием к работе. Ограничение допуска возникает при наличии у работника осложнений болезни (жизнеугрожающие нарушения ритма сердца, хроническая сердечная недостаточность III–IV функционального класса). Вместе с этим при бессимптомном необструктивном варианте гипертрофической кардиомиопатии важна оценка риска внезапной сердечной смерти по специальным шкалам риска. Допуск к работе с вредными условиями труда возможен при низком риске внезапной сердечной смерти. Таким образом, индивидуальная оценка профессиональной пригодности, основанная на комплексном анализе состояния пациента, данных стратификации риска внезапной сердечной смерти и соблюдении отраслевых нормативов, позволяет обеспечить безопасность труда без необоснованных ограничений.</p><sec><title>Участие авторов</title><p>Участие авторов:Горохова С.Г. — концепция и дизайн работы, обработка данных, написание текста;Алпаев Д.В. — сбор и обработка данных, написание текста; Корчагин И.А. — сбор и обработка данных;Стрижаков Л.А. — дизайн и редактирование;Атьков О.Ю. — концепция и редактирование.</p></sec><sec><title>Финансирование</title><p>Финансирование. Данная работа не имела спонсорской поддержки.</p></sec><sec><title>Конфликт интересов</title><p>Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.</p></sec><sec><title>Дата поступления</title><p>Дата поступления: 10.09.2025 / Дата принятия к печати: 06.10.2025 / Дата публикации: 30.10.2025</p></sec></abstract><trans-abstract xml:lang="en"><p>Hypertrophic cardiomyopathy (HCM) is a myocardial disease associated with the risk of sudden cardiac death (SCD). The scientists examined the criteria for diagnosis and anatomical and morphological types, phenocopies of HCM, algorithms for examination and risk stratification of SCD, necessary when addressing issues of professional suitability based on clinical recommendations and regulations (Order of the Ministry of Health of the Russian Federation No. 29n). The clinical observation of a patient with HCM who was sent for a mandatory periodic medical examination is presented. The analysis showed that, according to Order No. 29n, the diagnosis of HCM in itself does not serve as a medical contraindication to work. A restriction of admission occurs if an employee has complications of the disease (life-threatening cardiac arrhythmias, chronic heart failure of functional class III–IV). At the same time, with an asymptomatic, non-obstructive variant of HCM, it is important to assess the risk of SCD according to special risk scales. Access to work with harmful working conditions is possible with a low risk of SCD. Thus, an individual assessment of professional aptitude, based on a comprehensive analysis of the patient's condition, SCD risk stratification data and compliance with industry standards, makes it possible to ensure occupational safety without unreasonable restrictions.</p><sec><title>Contributions</title><p>Contributions:Gorokhova S.G. — concept and design of the study, data processing, writing;Alpaev D.V. — data collection and processing, writing;Korchagin I.A. — data collection and processing;Strizhakov L.A. — design and editing;Atkov O.Yu. — concept and editing.</p></sec><sec><title>Funding</title><p>Funding. The study had no funding.</p></sec><sec><title>Conflict of interest</title><p>Conflict of interest. The authors declare no conflict of interest.</p></sec><sec><title>Received</title><p>Received: 10.09.2025 / Accepted: 06.10.2025 / Published: 30.10.2025</p></sec></trans-abstract><kwd-group xml:lang="ru"><kwd>экспертиза профпригодности</kwd><kwd>гипертрофическая кардиомиопатия</kwd><kwd>гипертрофия левого желудочка</kwd><kwd>население трудоспособного возраста</kwd></kwd-group><kwd-group xml:lang="en"><kwd>professional aptitude examination</kwd><kwd>hypertrophic cardiomyopathy</kwd><kwd>left ventricular hypertrophy</kwd><kwd>working age population</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Шепель Р.Н., Самородская И.В., Какорина Е.П., Драпкина О.М. Динамика и структура смертности от хронической ишемической болезни сердца среди мужчин и женщин в Российской Федерации в 2014–2023 гг. 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