avkАрхивъ внутренней медициныThe Russian Archives of Internal Medicine2226-67042411-6564“SINAPS” LLC10.20514/2226-6704-2024-14-5-339-351HWSHUAavk-1850Research ArticleОБЗОРНЫЕ СТАТЬИREVIEW ARTICLESМетод усиленной наружной контрпульсации в клинической практикеThe Method of Enhanced External Counterpulsation in Clinical Practicehttps://orcid.org/0000-0001-8907-8370НиколаеваН. А.NikolaevaN. A.

Николаева Надежда Андреевна — аспирант, ассистент кафедры

Москва

Nadezhda A. Nikolaeva — postgraduate student, assistant of theDepartment

Moscow

nadnikolya@yandex.ruhttps://orcid.org/0000-0003-3391-0193ЛишутаА. С.LishutaA. S.

Лишута Алексей Сергеевич — к.м.н., профессор кафедры

Москва

Alexey S. Lishuta — candidate of medical sciences, professor of the department

Moscow

alexeylish@gmail.comhttps://orcid.org/0000-0002-4705-8037ВоронковаО. О.VoronkovaO. O.

Воронкова Ольга Олеговна — к.м.н., ассистент кафедры

Москва

Olga O. Voronkova — PhD, Assistant of the Department

Moscow

voronkova.oo@gmail.comhttps://orcid.org/0000-0002-1172-1116СлеповаО. А.SlepovaO. А.

Слепова Ольга Александровна — к.м.н., ассистент кафедры

Москва

Olga A. Slepova — candidate of medical sciences, assistant of the department

Moscow

slepova_o_a@staff.sechenov.ruhttps://orcid.org/0009-0006-6546-7041ПетуховаЮ. А.PetukhovaYu. A.

Петухова Юлия Алексеевна — студентка 5-ого курса

Москва

Yulia A. Petukhova — 5th year student

Moscow

juliya.petukhova@mail.ruhttps://orcid.org/0000-0002-3014-6129БеленковЮ. Н.BelenkovYu. N.

Беленков Юрий Никитич — академик РАН, профессор, д.м.н., заведующий кафедрой 

Москва

Yuri N. Belenkov — Academician of the Russian Academy of Sciences, Professor, Doctor of Medical Sciences, Head of the Department

Moscow

belenkov_yu_n@staff.sechenov.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет), Кафедра госпитальной терапии № 1 Института клинической медицины, им. Н.В. СклифосовскогоРоссияMoscow State Medical University n.a. I.M. Sechenov (Sechenov University), Department of Hospital Therapy № 1 of the Institute of Clinical Medicine n.a. N.V. SklifosovskyRussian Federation202413102024145339351Copyright © Николаева Н.А., Лишута А.С., Воронкова О.О., Слепова О.А., Петухова Ю.А., Беленков Ю.Н., 20242024Николаева Н.А., Лишута А.С., Воронкова О.О., Слепова О.А., Петухова Ю.А., Беленков Ю.Н.Nikolaeva N.A., Lishuta A.S., Voronkova O.O., Slepova O.А., Petukhova Y.A., Belenkov Y.N.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.medarhive.ru/jour/article/view/1850

Хронические неинфекционные заболевания представляют важную медико-социальную проблему для системы здравоохранения. Оптимальная фармакотерапия не всегда оказывается достаточно эффективной, а применение хирургических методов лечения возможно не у всех больных. Кроме того, важным звеном комплексного ведения таких пациентов является дозированная физическая активность, однако у большинства из них низкая толерантность к нагрузкам не позволяет их осуществлять, запуская порочный круг, приводящий к снижению функционального резерва организма. В данном случае полезным может быть использование немедикаментозных методов лечения, например, усиленной наружной контрпульсации. Настоящий обзор посвящен анализу литературных данных о возможностях использования данного метода, что имеет существенное значение в клинической практике.

Chronic non- infectious diseases represent an important medical and social problem for the healthcare system. Optimal pharmacotherapy is not always effective enough, and the use of surgical treatment methods is not possible in all patients. In addition, an important link in the comprehensive management of such patients is dosed physical activity, however, in most of them, low exercise tolerance does not allow them to exercise, starting a vicious circle that leads to a decrease in the functional reserve of the body. In this case, the use of non-pharmacological treatment methods, for example, enhanced external counterpulsation, may be useful. This review is devoted to the analysis of literature data on the possibilities of using this method, which is important in clinical practice.

хронические неинфекционные заболеванияусиленная наружная контрпульсациянемедикаментозные методы леченияchronic non- infectious diseasesenhanced external counterpulsationnon-pharmacological treatment methodsАвторы заявляют об отсутствии финансирования при проведении исследованияThe authors declare no funding for this studyReferencesWHO. Noncommunicable Diseases: Mortality (2019). [Electronic resource]. URL: https://www.who.int/gho/ncd/mortality_morbidity/en/. (date of the application: 15.04.2024).WHO. Noncommunicable Diseases: Mortality (2019). [Electronic resource]. URL: https://www.who.int/gho/ncd/mortality_morbidity/en/. (date of the application: 15.04.2024).Barnett K., Mercer S.W., Norbury M., et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012 Jul 7; 380(9836): 37-43. doi: 10.1016/S0140-6736(12)60240-2.Barnett K., Mercer S.W., Norbury M., et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. Lancet 2012 Jul 7; 380(9836): 37-43. doi: 10.1016/S0140-6736(12)60240-2.Драпкина О.М., Концевая А.В., Калинина А.М. и др. Профилактика хронических неинфекционных заболеваний в Российской Федерации. Национальное руководство 2022. Кардиоваскулярная терапия и профилактика. 2022; 21(4): 3235. doi: 10.15829/1728-8800-2022-3235.Drapkina O.M., Kontsevaya A.V., Kalinina A.M., et al. 2022 Prevention of chronic non-communicable diseases in the Russian Federation. National guidelines. Cardiovascular Therapy and Prevention. 2022; 21(4): 3235. doi: 10.15829/1728-8800-2022-3235. [In Russian]Pasanen T., Tolvanen S., Heinonen A., et al. Exercise therapy for functional capacity in chronic diseases: an overview of metaanalyses of randomised controlled trials. Br J Sports Med. 2017 Oct; 51(20): 1459-1465. doi: 10.1136/bjsports-2016-097132.Pasanen T., Tolvanen S., Heinonen A., et al. Exercise therapy for functional capacity in chronic diseases: an overview of metaanalyses of randomised controlled trials. Br J Sports Med. 2017 Oct; 51(20): 1459-1465. doi: 10.1136/bjsports-2016-097132.Мамиева З.А., Лишута А.С., Беленков Ю.Н. и др. Возможности применения усиленной наружной контрпульсации в клинической практике. Рациональная Фармакотерапия в Кардиологии 2017; 13(2): 238-247. doi: 10.20996/1819-6446-2017-13-2-238-2475.Mamieva Z.A., Lishuta A .S., Belenkov Yu.N., et al. The possibilities of using enhanced external counterpulsation in clinical practice. Rational Pharmacotherapy in Cardiology 2017; 13(2): 238-247. doi: 10.20996/1819-6446-2017-13-2-238-2475. [In Russian]Бокерия Л.А., Бокерия О.Л., Полякова У.А. Наружная контрпульсация в лечении больных ишемической болезнью сердца: от механизмов действия до клинических результатов. Грудная и сердечно-сосудистая хирургия, 2012; 54 (2): 47-54.Bokeria L.A., Bokeria O.L., Polyakova U.A. External counterpulsation in the treatment of patients with coronary heart disease: from mechanisms of action to clinical results. Thoracic and Cardiovascular surgery, 2012; 54 (2): 47-54. [In Russian]Рябов В.В., Антипова М.А., Юдина Н.В. и др. Влияние наружной контрпульсации на вазорегулирующую и атромбогенную функции сосудистого эндотелия у больных стенокардией напряжения. Сибирский медицинский журнал, 2013; 28 (1): 11–17.Ryabov V.V., Antipova M.A., Yudina N.V. et al. The effect of external contrapulsation on vasoregulatory and atrombogenic functions of the vascular endothelium in patients with angina pectoris. Siberian Medical Journal, 2013; 28 (1): 11-17.Akhtar M., Wu G.F., Du Z.M. et al. Effect of external counterpulsation on plasma nitric oxide and endothelin-1 levels. Journal of the American College of Cardiology. 2006; 98(1): 28-30. doi: 10.1016/j.amjcard.2006.01.053.Akhtar M., Wu G.F., Du Z.M. et al. Effect of external counterpulsation on plasma nitric oxide and endothelin-1 levels. Journal of the American College of Cardiology. 2006; 98(1): 28-30. doi: 10.1016/j.amjcard.2006.01.053.Xu L., Chen X., Cui M. et al. The improvement of the shear stress and oscillatory shear index of coronary arteries during Enhanced External Counterpulsation in patients with coronary heart disease. PLoS One. 2020 Mar 19; 15(3): e0230144. doi: 10.1371/journal.pone.0230144.Xu L., Chen X., Cui M. et al. The improvement of the shear stress and oscillatory shear index of coronary arteries during Enhanced External Counterpulsation in patients with coronary heart disease. PLoS One. 2020 Mar 19; 15(3): e0230144. doi: 10.1371/journal.pone.0230144.Qin X., Deng Y., Wu D. et al. Does Enhanced External Counterpulsation (EECP) Significantly Affect Myocardial Perfusion? A Systematic Review & Meta-Analysis. PLoS One. 2016 Apr 5; 11(4): e0151822. doi: 10.1371/journal.pone.0151822.Qin X., Deng Y., Wu D. et al. Does Enhanced External Counterpulsation (EECP) Significantly Affect Myocardial Perfusion? A Systematic Review & Meta-Analysis. PLoS One. 2016 Apr 5; 11(4): e0151822. doi: 10.1371/journal.pone.0151822.Russo T.A., Banuth A.M., Nader H.B. et al. Altered shear stress on endothelial cells leads to remodeling of extracellular matrix and induction of angiogenesis. PLoS One. 2020 Nov 19; 15(11): e0241040. doi: 10.1371/journal.pone.0241040.Russo T.A., Banuth A.M., Nader H.B. et al. Altered shear stress on endothelial cells leads to remodeling of extracellular matrix and induction of angiogenesis. PLoS One. 2020 Nov 19; 15(11): e0241040. doi: 10.1371/journal.pone.0241040.Мареев В.Ю., Фомин И.В., Агеев Ф.Т., и др. Клинические рекомендации ОССН — РКО — РНМОТ. Сердечная недостаточность: хроническая (ХСН) и острая декомпенсированная (ОДСН). Диагностика, профилактика и лечение. Кардиология. 2018; 58(6S): 8-158. doi: 10.18087/cardio.2475Mareev V.Yu., Fomin I.V., Ageev F.T. et al. Russian Heart Failure Society, Russian Society of Cardiology. Russian Scientific Medical Society of Internal Medicine Guidelines for Heart failure: chronic (CHF) and acute decompensated (ADHF). Diagnosis, prevention and treatment. Kardiologiia. 2018; 58(6S): 8-158. doi: 10.18087/cardio.2475. [In Russian]Стабильная ишемическая болезнь сердца. Клинические рекомендации 2020. Российский кардиологический журнал. 2020; 25(11): 4076. doi: 10.15829/1560-4071-2020-4076.2020Clinical practice guidelines for Stable coronary artery disease. Russian Journal of Cardiology. 2020; 25(11): 4076. doi: 10.15829/1560-4071-2020-4076. [In Russian]Knuuti J. 2019 Рекомендации ЕSC по диагностике и лечению хронического коронарного синдрома. Российский кардиологический журнал. 2020; 25(2): 3757. doi: 10.15829/1560-4071-2020-2-3757.Knuuti J. 2019 ESC Guidelines for the diagnosis and management of chronic coronary syndromes The Task Force for the diagnosis and management of chronic coronary syndromes of the European Society of Cardiology (ESC). Russian Journal of Cardiology. 2020; 25(2): 3757. doi: 10.15829/1560-4071-2020-2-3757. [In Russian]Приказ Министерства Здравоохранения Российской Федерации от 28 апреля 2021 г. № 410н «Об утверждении стандарта медицинской помощи взрослым при стабильной ишемической болезни сердца (диагностика, лечение и диспансерное наблюдение)». [Электронный ресурс]. URL: https://www.consultant.ru/document/cons_doc_LAW_384782/ (дата обращения 25.04.2024).Приказ Министерства Здравоохранения Российской Федерации от 28 апреля 2021 г. № 410н «Об утверждении стандарта медицинской помощи взрослым при стабильной ишемической болезни сердца (диагностика, лечение и диспансерное наблюдение)». [Электронный ресурс]. URL: https://www.consultant.ru/document/cons_doc_LAW_384782/ (дата обращения 25.04.2024).Приказ Министерства Здравоохранения Российской Федерации от 24 декабря 2012 г. № 1554н (ред. от 20.04.2022) «Об утверждении стандарта специализированной медицинской помощи при сердечной недостаточности» [Электронный ресурс]. URL: https://www.consultant.ru/document/cons_doc_LAW_145585/ (дата обращения 25.04.2024).Приказ Министерства Здравоохранения Российской Федерации от 24 декабря 2012 г. № 1554н (ред. от 20.04.2022) «Об утверждении стандарта специализированной медицинской помощи при сердечной недостаточности» [Электронный ресурс]. URL: https://www.consultant.ru/document/cons_doc_LAW_145585/ (дата обращения 25.04.2024).Lin S., Xiao-Ming W., Gui-Fu W. Expert consensus on the clinical application of enhanced external counterpulsation in elderly people (2019). Aging Med. (Milton). 2020; 3(1): 16–24. doi: 10.1002/agm2.12097.Lin S., Xiao-Ming W., Gui-Fu W. Expert consensus on the clinical application of enhanced external counterpulsation in elderly people (2019). Aging Med. (Milton). 2020; 3(1): 16–24. doi: 10.1002/agm2.12097.Caceres J., Atal P., Arora R., et al. Enhanced external counterpulsation: A unique treatment for the “No-Option” refractory angina patient. J Clin Pharm Ther. 2021 Apr; 46(2): 295-303. doi: 10.1111/jcpt.13330. Epub 2021 Jan 7.Caceres J., Atal P., Arora R., et al. Enhanced external counterpulsation: A unique treatment for the “No-Option” refractory angina patient. J Clin Pharm Ther. 2021 Apr; 46(2): 295-303. doi: 10.1111/jcpt.13330. Epub 2021 Jan 7.Габрусенко С.А., Малахов В.В., Масенко В.П. Использование метода наружной контрпульсации в комплексном лечении больных ишемической болезнью сердца. Атеросклероз и дислипидемии. 2010; 1: 31-36Gabrusenko S.A., Malakhov V.V., Masenko V.P., The use of the method of external counterpulsation in the complex treatment of patients with coronary heart disease. Atherosclerosis and Dyslipidemia. 2010; 1: 31-36 [In Russian]Arora R.R., Chou T.M., Jain D., et al. The multicenter study of enhanced external counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and anginal episodes. J Am Coll Cardiol. 1999 Jun; 33(7): 1833-40. doi: 10.1016/s0735-1097(99)00140-0.Arora R.R., Chou T.M., Jain D., et al. The multicenter study of enhanced external counterpulsation (MUST-EECP): effect of EECP on exercise-induced myocardial ischemia and anginal episodes. J Am Coll Cardiol. 1999 Jun; 33(7): 1833-40. doi: 10.1016/s0735-1097(99)00140-0.Singh V., Kumari G., Chhajer B., et al. Enhanced external counterpulsation effectiveness on clinical parameters in diabetic and non-diabetic coronary heart disease patients. Asian Journal of Pharmaceutical and Clinical Research. 2018; 11(7): 151-157. doi: 10.22159/ajpcr.2018.v11i7.25219.Singh V., Kumari G., Chhajer B., et al. Enhanced external counterpulsation effectiveness on clinical parameters in diabetic and non-diabetic coronary heart disease patients. Asian Journal of Pharmaceutical and Clinical Research. 2018; 11(7): 151-157. doi: 10.22159/ajpcr.2018.v11i7.25219.Subramanian R., Nayar S., Meyyappan C., et al. Effect of Enhanced External Counter Pulsation Treatment on Aortic Blood Pressure, Arterial Stiffness and Ejection Fraction in Patients with Coronary Artery Disease. J Clin Diagn Res. 2016 Oct; 10(10): OC30-OC34. doi: 10.7860/JCDR/2016/23122.8743.Subramanian R., Nayar S., Meyyappan C., et al. Effect of Enhanced External Counter Pulsation Treatment on Aortic Blood Pressure, Arterial Stiffness and Ejection Fraction in Patients with Coronary Artery Disease. J Clin Diagn Res. 2016 Oct; 10(10): OC30-OC34. doi: 10.7860/JCDR/2016/23122.8743.Sardari A., Hosseini S.K., Bozorgi A. et al. Effects of Enhanced External Counterpulsation on Heart Rate Recovery in Patients with Coronary Artery Disease. J Tehran Heart Cent. 2018 Jan; 13(1): 13-17.Sardari A., Hosseini S.K., Bozorgi A. et al. Effects of Enhanced External Counterpulsation on Heart Rate Recovery in Patients with Coronary Artery Disease. J Tehran Heart Cent. 2018 Jan; 13(1): 13-17.Wu E., Mårtensson J., Broström A. Enhanced external counterpulsation in patients with refractory angina pectoris: a pilot study with six months follow-up regarding physical capacity and health-related quality of life. Eur J CardiovascNurs. 2013 Oct; 12(5): 437-45. doi: 10.1177/1474515112468067.Wu E., Mårtensson J., Broström A. Enhanced external counterpulsation in patients with refractory angina pectoris: a pilot study with six months follow-up regarding physical capacity and health-related quality of life. Eur J CardiovascNurs. 2013 Oct; 12(5): 437-45. doi: 10.1177/1474515112468067.Беленков Ю.Н., Лишута А.С., Слепова О.А. и др. Исследование EXCEL: длительное наблюдение эффективности медикаментозной и немедикаментозной реабилитации больных сердечной недостаточностью ишемической этиологии. Кардиология. 2024; 64(1): 14–24. doi: 10.18087/cardio.2024.1.n2615.Belenkov Yu.N., Lishuta A.S., Slepova O.A., et al. The EXCEL Study: Long-term Observation of the Effectiveness of Drug and Non-drug Rehabilitation in Patients with Ischemic Heart Failure. Kardiologiia. 2024; 64(1): 14-24. doi: 10.18087/cardio.2024.1.n2615. [In Russian]Лишута А.С., Слепова О.А., Николаева Н.С. и др. Долгосрочные эффекты усиленной наружной контрпульсации в ведении пациентов с ишемической болезнью сердца, осложненной сердечной недостаточностью: данные исследования EXCEL. Российский кардиологический журнал. 2024; 29(6): 5886. doi: 10.15829/1560-4071-2024-5886.Lishuta A.S., Slepova O.A., Nikolaeva N.S., et al. Long-term effects of enhanced external counterpulsation in the management of patients with coronary artery disease complicated by heart failure: data from the EXCEL study. Russian Journal of Cardiology. 2024; 29(6): 5886. doi: 10.15829/1560-4071-2024-5886. [In Russian]Thakkar B.V., Hirsch A.T., Satran D., et al. The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease. Vasc Med. 2010 Feb; 15(1): 15-20. doi: 10.1177/1358863X09106549.Thakkar B.V., Hirsch A.T., Satran D., et al. The efficacy and safety of enhanced external counterpulsation in patients with peripheral arterial disease. Vasc Med. 2010 Feb; 15(1): 15-20. doi: 10.1177/1358863X09106549.Бадтиева В.А., Ворошилова Д.Н., Cичинава Н.В. Применение метода усиленной наружной контрпульсации в лечении и реабилитации пациентов с облитерирующим атеросклерозом сосудов нижних конечностей. Вопросы курортологии, физиотерапии и лечебной физической культуры. 2019; 96(4): 5-11. doi: 10.17116/kurort2019960415.Badtieva V.A., Voroshilova D.N., Sichinava N.V. Use of enhanced external counterpulsation in the treatment and rehabilitation of patients with atherosclerosis obliterans of the lower extremity. Problems of balneology, physiotherapy, and exercise therapy. 2019; 96(4): 5-11. doi: 10.17116/kurort2019960415. [In Russian]Liang J., Shi J., Wei W., et al. External Counterpulsation Attenuates Hypertensive Vascular Injury Through Enhancing the Function of Endothelial Progenitor Cells. Front Physiol. 2021 Feb 12; 11: 590585. doi: 10.3389/fphys.2020.590585.Liang J., Shi J., Wei W., et al. External Counterpulsation Attenuates Hypertensive Vascular Injury Through Enhancing the Function of Endothelial Progenitor Cells. Front Physiol. 2021 Feb 12; 11: 590585. doi: 10.3389/fphys.2020.590585.Zhao M., Huang Y., Li L., et al. Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial. Int J Chron Obstruct Pulmon Dis. 2020 Jan 7; 15: 25-31. doi: 10.2147/COPD.S225566.Zhao M., Huang Y., Li L., et al. Enhanced External Counterpulsation Efficacy on Exercise Endurance in COPD Patients and Healthy Subjects: A Pilot Randomized Clinical Trial. Int J Chron Obstruct Pulmon Dis. 2020 Jan 7; 15: 25-31. doi: 10.2147/COPD.S225566.Sathyamoorthy M., Verduzco-Gutierrez M., Varanasi S., et al. Enhanced external counterpulsation for management of symptoms associated with long COVID. Am Heart J Plus. 2022 Feb 12; 13: 100105. doi: 10.1016/j.ahjo.2022.100105.Sathyamoorthy M., Verduzco-Gutierrez M., Varanasi S., et al. Enhanced external counterpulsation for management of symptoms associated with long COVID. Am Heart J Plus. 2022 Feb 12; 13: 100105. doi: 10.1016/j.ahjo.2022.100105.Николаева Н.А., Беленков Ю.Н., Лишута А.С. и др. Усиленная наружная контрпульсация как средство немедикаментозного лечения пациентов с тяжелыми и среднетяжелыми вентиляционными нарушениями. Терапия. 2023; 9(6): 8–14. doi: 10.18565/therapy.2023.6.8–14.Nikolaeva N.A., Belenkov Yu.N., Lishuta A.S., et al. Enhanced external counterpulsation as a measure of non-drug treatment of patients with severe and moderate ventilation disorders. Therapy. 2023; 9(6): 8–14. doi: 10.18565/therapy.2023.6.8–14. [In Russian]Dayrit J.K., Verduzco-Gutierrez M., Teal A., et al. Enhanced External Counterpulsation as a Novel Treatment for Postacute COVID-19 Sequelae. Cureus. 2021 Apr 7; 13(4): e14358. doi: 10.7759/cureus.14358.Dayrit J.K., Verduzco-Gutierrez M., Teal A., et al. Enhanced External Counterpulsation as a Novel Treatment for Postacute COVID-19 Sequelae. Cureus. 2021 Apr 7; 13(4): e14358. doi: 10.7759/cureus.14358.Barreiro E., Sznajder J.I., Nader G.A., et al. Muscle dysfunction in patients with lung diseases: a growing epidemic. Am J Respir Crit Care Med. 2015 Mar 15; 191(6): 616-9. doi: 10.1164/rccm.201412-2189OE.Barreiro E., Sznajder J.I., Nader G.A., et al. Muscle dysfunction in patients with lung diseases: a growing epidemic. Am J Respir Crit Care Med. 2015 Mar 15; 191(6): 616-9. doi: 10.1164/rccm.201412-2189OE.Melin M., Montelius A., Ryden L., et al. Effects of enhanced external counterpulsation on skeletal muscle gene expression in patients with severe heart failure. Clin Physiol Funct Imaging. 2018; 38(1): 118–127. doi :10.1111/cpf.12392.Melin M., Montelius A., Ryden L., et al. Effects of enhanced external counterpulsation on skeletal muscle gene expression in patients with severe heart failure. Clin Physiol Funct Imaging. 2018; 38(1): 118–127. doi :10.1111/cpf.12392.Sardina P.D., Martin J.S., Avery J.C., et al. Enhanced external counterpulsation (EECP) improves biomarkers of glycemic control in patients with non-insulin-dependent type II diabetes mellitus for up to 3 months following treatment. ActaDiabetol. 2016 Oct; 53(5): 745-52. doi: 10.1007/s00592-016-0866-9.Sardina P.D., Martin J.S., Avery J.C., et al. Enhanced external counterpulsation (EECP) improves biomarkers of glycemic control in patients with non-insulin-dependent type II diabetes mellitus for up to 3 months following treatment. ActaDiabetol. 2016 Oct; 53(5): 745-52. doi: 10.1007/s00592-016-0866-9.Sardina P.D., Martin J.S., Dzieza W.K., et al. Enhanced external counterpulsation (EECP) decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment. Acta Diabetol. 2016 Oct; 53(5): 753-60. doi: 10.1007/s00592-016-0869-6.Sardina P.D., Martin J.S., Dzieza W.K., et al. Enhanced external counterpulsation (EECP) decreases advanced glycation end products and proinflammatory cytokines in patients with non-insulin-dependent type II diabetes mellitus for up to 6 months following treatment. Acta Diabetol. 2016 Oct; 53(5): 753-60. doi: 10.1007/s00592-016-0869-6.Li H.L., Zhou J.W., Zuo W. Effects of external counter-pulsation combined with laser photocoagulation fortreatment of nonproliferative diabetic retinopathy. Guoji Yanke Zazhi. 2016; 16 (11): 2082–4. doi: 10.3980/j.issn.1672-5123.2016.11.24.Li H.L., Zhou J.W., Zuo W. Effects of external counter-pulsation combined with laser photocoagulation fortreatment of nonproliferative diabetic retinopathy. Guoji Yanke Zazhi. 2016; 16 (11): 2082–4. doi: 10.3980/j.issn.1672-5123.2016.11.24.Liu C.T., Wang X.J., Li X, et al. Effects of enhanced extracorporeal counterpulsation on early renal injury in elderly patients with type 2 diabetic nephropathy. Chin J Clin Res. 2017; 30(3): 342-344.Liu C.T., Wang X.J., Li X, et al. Effects of enhanced extracorporeal counterpulsation on early renal injury in elderly patients with type 2 diabetic nephropathy. Chin J Clin Res. 2017; 30(3): 342-344.Duan H.Y. Clinical efficacy analysis of enhanced external counterpulsation in the treatment of diabetic nephropathy. Jf Youjiang Med Univ Nationalities. 2015; 3: 384-386.Duan H.Y. Clinical efficacy analysis of enhanced external counterpulsation in the treatment of diabetic nephropathy. Jf Youjiang Med Univ Nationalities. 2015; 3: 384-386.Энеева М.А., Костенко Е.В., Разумов А.Н. и др. Усиленная наружная контрпульсация — метод неинвазивного вспомогательного кровообращения в комплексном восстановительном лечении пациентов после ишемического инсульта (обзор). Вопросы курортологии, физиотерапии и лечебной физической культуры. 2015; 92(3): 45-52. doi: 10.17116/kurort2015345-52.Eneeva M.A., Kostenko E.V., Razumov A.N., et al. Enhanced external counterpulsation — a method of noninvasive auxiliary blood circulation in the complex rehabilitation treatment of patients after ischemic stroke (review). Issues of balneology, physiotherapy and therapeutic physical education. 2015; 92(3): 45-52. doi: 10.17116/kurort2015345-52. [In Russian]Liu J.Y., Xiong L., Stinear C.M., et al. External counterpulsation enhances neuroplasticity to promote stroke recovery. J NeurolNeurosurg Psychiatry. 2019 Mar; 90(3): 361-363. doi: 10.1136/jnnp-2018-318185.Liu J.Y., Xiong L., Stinear C.M., et al. External counterpulsation enhances neuroplasticity to promote stroke recovery. J NeurolNeurosurg Psychiatry. 2019 Mar; 90(3): 361-363. doi: 10.1136/jnnp-2018-318185.Kozdağ G., Işeri P., Gökçe G., et al.Treatment with enhanced external counterpulsation improves cognitive functions in chronic heart failure patients. Turk Kardiyol Dern Ars. 2013 Jul; 41(5): 418-28. doi: 10.5543/tkda.2013.24366.Kozdağ G., Işeri P., Gökçe G., et al.Treatment with enhanced external counterpulsation improves cognitive functions in chronic heart failure patients. Turk Kardiyol Dern Ars. 2013 Jul; 41(5): 418-28. doi: 10.5543/tkda.2013.24366.Zhou Q. Observation of 33 cases of Parkinson’s disease treated with external counterpulsation. J. Luzhou Med.Coll. 2004; 27 (1): 56–7.Zhou Q. Observation of 33 cases of Parkinson’s disease treated with external counterpulsation. J. Luzhou Med.Coll. 2004; 27 (1): 56–7.Gottlieb S.S., Piña I.L. Enhanced external counterpulsation: what can we learn from the treatment of neurasthenia? J Am Coll Cardiol. 2006 Sep 19; 48(6): 1206-7. doi: 10.1016/j.jacc.2006.04.054.Gottlieb S.S., Piña I.L. Enhanced external counterpulsation: what can we learn from the treatment of neurasthenia? J Am Coll Cardiol. 2006 Sep 19; 48(6): 1206-7. doi: 10.1016/j.jacc.2006.04.054.Yang Y., Zhang H., Yan Y., et al. Clinical study in patients with ocular ischemic diseases treated with enhanced external counterpulsation combined with drugs. Mol Med Rep. 2013 Jun; 7(6): 1845-9. doi: 10.3892/mmr.2013.1445.Yang Y., Zhang H., Yan Y., et al. Clinical study in patients with ocular ischemic diseases treated with enhanced external counterpulsation combined with drugs. Mol Med Rep. 2013 Jun; 7(6): 1845-9. doi: 10.3892/mmr.2013.1445.Zhu W., Liao R., Chen Y., et al. Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2015 Jan; 253(1): 127-33. doi: 10.1007/s00417-014-2823-z.Zhu W., Liao R., Chen Y., et al. Effect of enhanced extracorporeal counterpulsation in patients with non-arteritic anterior ischaemic optic neuropathy. Graefes Arch Clin Exp Ophthalmol. 2015 Jan; 253(1): 127-33. doi: 10.1007/s00417-014-2823-z.Offergeld C., Werner D., Schneider M., et al. Die pneumatische externe Gegenpulsation (PECP): Neue Behandlungsmöglichkeit bei therapierefraktären Innenohrstörungen? [Pneumatic external counterpulsation (PECP): a new treatment option in therapy refractory inner ear disorders?]. Laryngorhinootologie. 2000 Sep; 79(9): 503-9. German. doi: 10.1055/s-2000-6941.Offergeld C., Werner D., Schneider M., et al. Die pneumatische externe Gegenpulsation (PECP): Neue Behandlungsmöglichkeit bei therapierefraktären Innenohrstörungen? [Pneumatic external counterpulsation (PECP): a new treatment option in therapy refractory inner ear disorders?]. Laryngorhinootologie. 2000 Sep; 79(9): 503-9. German. doi: 10.1055/s-2000-6941.Froschermaier S.E., Werner D., Leike S., et al. Enhanced external counterpulsation as a new treatment modality for patients with erectile dysfunction. Urol Int. 1998; 61(3): 168-71. doi: 10.1159/000030315.Froschermaier S.E., Werner D., Leike S., et al. Enhanced external counterpulsation as a new treatment modality for patients with erectile dysfunction. Urol Int. 1998; 61(3): 168-71. doi: 10.1159/000030315.Lawson W.E., Hui J.C., Kennard E.D., et al. Effect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunction. Int J ClinPract. 2007 May; 61(5): 757-62. doi: 10.1111/j.1742-1241.2007.01328.x.Lawson W.E., Hui J.C., Kennard E.D., et al. Effect of enhanced external counterpulsation on medically refractory angina patients with erectile dysfunction. Int J ClinPract. 2007 May; 61(5): 757-62. doi: 10.1111/j.1742-1241.2007.01328.x.

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