CRCardiovascular Reviews3083-48802981-8109Bio-Byword Scientific Publishing Pty. Ltd.10.26689/CR.v4i3.15630ArticleApplication Effect of Enhanced External Counterpulsation in Patients with Chronic Heart Failure Comorbid with Type 2 Diabetes Mellitushttps://artdesignp.com/journal/CR/4/3/10.26689/CR.v4i3.15630LiuAihua,CuiZhihua,RenZhiru,SunLina,GaoXiaoying,RenYaoxiang2026432026-09-30Objective: To analyze the effects of enhanced external counterpulsation on cardiac function, blood glucose, and exercise tolerance in patients with chronic heart failure comorbid with type 2 diabetes mellitus, and to evaluate the application efficacy of this therapy in this population. Methods: From August 2025 to October 2026, patients with chronic heart failure and diabetes admitted to our hospital were enrolled and randomly divided into a control group (n = 75) and an observation group (n = 75) using a random number table method. The control group received standard medication and routine health education, while the observation group received additional external counterpulsation therapy, 30 minutes per session, twice daily, 6 hours per week, for a total of 6 weeks, accumulating one course of counterpulsation with a total duration of 36 hours. Results: In terms of cardiac function indicators, after one course of treatment and at 3 months, the observation group showed higher left ventricular ejection fraction (LVEF) and lower left ventricular end‑diastolic diameter (LVEDD) and N‑terminal pro‑B‑type natriuretic peptide (NT‑proBNP) compared with the control group (P < 0.05). For exercise tolerance, the 6‑minute walk test (6MWT) distance, anaerobic threshold (AT), and maximal metabolic equivalent (METS) were all higher in the observation group than in the control group (P < 0.05). Regarding glycemic control, fasting plasma glucose (FPG), 2‑hour postprandial glucose (2hPG), and glycated hemoglobin (HbA1c) were all lower in the observation group (P < 0.05). Conclusion: External counterpulsation therapy in patients with chronic heart failure and type 2 diabetes mellitus can improve cardiac function, enhance exercise tolerance, and ameliorate glycemic levels, representing a non‑pharmacological treatment modality worthy of broader clinical promotion.Chronic heart failure, Type 2 diabetes mellitus, Enhanced external counterpulsation

[1]   Zhang J, Zhang YH, Huang J, 2023, National Heart Failure Guideline 2023 (Abridged Version). Chinese Circulation Journal, 38(12): 1207–1238. [2]   Heidenreich PA, Bozkurt B, Aguilar D, et al., 2022, 2022 AHA/ACC/HFSA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol, 79(17): e263–e421. [3]   Chinese Diabetes Society, 2021, Guideline for the Prevention and Treatment of Type 2 Diabetes in China (2020 Edition). Chinese Journal of Endocrinology and Metabolism, 37(4): 311–398. [4]   Marx N, Federici M, Schütt K, et al., 2023, 2023 ESC Guidelines for the Management of Cardiovascular Disease in Patients with Diabetes. Eur Heart J, 44(39): 4043–4140. [5]   Chatterjee S, Khunti K, Davies MJ, 2017, Type 2 Diabetes. Lancet, 389(10085): 2239–2251. [6]   Seferović PM, Petrie MC, Filippatos GS, et al., 2018, Type 2 Diabetes Mellitus and Heart Failure: A Position Statement from the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail, 20(5): 853–872. [7]   Schütt K, 2024, Rethinking the Impact and Management of Diabetes in Heart Failure Patients. Curr Heart Fail Rep, 21(1): 53–60. [8]   Zhang H, Xu PC, Ma L, 2024, Research Progress on Prevention and Treatment of Comorbid Type 2 Diabetes and Heart Failure. Chinese Journal of New Clinical Medicine, 17(4): 467–471. [9]   Dunlay SM, Givertz MM, Aguilar D, et al., 2019, Type 2 Diabetes Mellitus and Heart Failure: A Scientific Statement From the American Heart Association and the Heart Failure Society of America: This Statement Does Not Represent an Update of the 2017 ACC/AHA/HFSA Heart Failure Guideline Update. Circulation, 140(7): e294–e324. [10] Park JJ, 2021, Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes. Diabetes Metab J, 45(2): 146–157. [11] Zareini B, Blanche P, Holt A, et al., 2022, The Burden of Cardiovascular Outcomes in Heart Failure Patients with New Onset, Prevalent, and Without Type 2 Diabetes. Clin Res Cardiol, 111(4): 460–468. [12] Shen L, Leng XY, Zhang XX, et al., 2024, Chinese Expert Consensus on Quality Control Management and Clinical Efficacy Evaluation of Enhanced External Counterpulsation. Journal of Clinical Cardiology, 40(10): 775–784. [13] Nagendra L, Dutta D, Sharma M, et al., 2023, Impact of Enhanced External Counterpulsation Therapy on Glycaemic Control in People With Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. touchREV Endocrinol, 19(2): 9–15.