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Table 1 General characteristics and quality assessment of included studies

From: Prevalence of left ventricular systolic dysfunction and heart failure with reduced ejection fraction in men and women with type 2 diabetes mellitus: a systematic review and meta-analysis

Author (year)

Source population and setting

Agea

Participants (% male)

T2D duration (years) [mean ± SD or median (range)]

Exclusion criteria

Cut-point LVEF to separate LVSD from LVDD (%)

Presence of heart failure assessed (yes/no)

Risk of bias (low/high)

Overall risk (low/medium/high)

a

b

c

d

e

f

g

h

i

Annonu (2001)

Patients attending the Diabetic Center of Cairo University hospital, Egypt

39–64 57 ± 6.8

66 (53%)

Not reported

Insulin use, alcoholism, clinical or electrocardiographic evidence of heart diseases and hypertension

50

No

L

H

H

H

L

L

L

L

L

Medium

Fang (2005)

Asymptomatic patients from the ambulatory Diabetes Clinic at Princess Alexandra Hospital, Australia.

No age range or overall mean age reported

101 (not reported)

Not reported

History of complaints of cardiac disease, history of coronary artery disease, valvular disease, atrial fibrillation, severe arrhythmias and congenital heart disease

50

No

L

H

L

H

H

L

L

H

H

High

Dawson (2005)

Random volunteers from the Diabetes Centre, Ninewells Hospital, Scotland

63.8 ± 10.6

500 (61.6%)

6.0 ± 5.5

Frailty and inability to give written informed consent

45

No

L

L

L

L

L

L

L

H

H

Medium

Albertini (2008)

Consecutive asymptomatic patients admitted at the Avicenne Hospital endocrinology unit, France

59.8 ± 1.5

91 (54%)

13 ± 1.1

Previous or suspected history of heart disease, intrinsic lung or overt renal disease, incomplete echocardiographic data or poor echogenicity

50

No

L

H

L

H

L

L

L

L

L

Medium

Chaowalit (2006)

Patients referred for clinically indicated dobutamine stress echo, US

67 ± 11

2349 (57%)

Not reported

None

55

No

H

H

H

L

L

L

L

L

L

Medium

Srivastava (2008)

Patients referred for echocardiography as part of a routine complications surveillance programme, mainly by general practitioners (80%) and 20% from the hospital, at the Diabetic Clinic at Austin Health, Australia

62 ± 1

229 (58%)

10 ± 1

None

50

No

L

L

H

H

L

L

L

H

L

Medium

Poulsen (2010)

Patients referred, for the first time, for diabetes education or poorly regulated diabetes to the Diabetes Clinic at Odense University Hospital, Denmark

58.6 ± 11.3

305 (54%)

4.5 ± 5.3

History of CVD, malignancy or End-stage kidney disease, pregnancy, body weight > 150 kg, physical or mental disability, not able to provide inform consent

50

No

L

H

L

H

L

L

L

L

L

Medium

Aigbe (2012)

Randomly selected patients at the University Teaching Hospital, Nigeria

26–80 55.4 ± 11.6

300 (150 cases, 43% male)

4.5 ± 4.5

Hypertension, pregnancy, sickle cell disease and structural heart disease

50

No

L

H

L

H

L

L

L

L

H

Medium

Boonman-de Winter (2012)

Patients enrolled in the Diabetes Care programme of the Center for Diagnostic Support in Primary Care, the Netherlands

71.5 ± 7.5

581 (53%)

Not reported

None

45

Yes

L

L

L

H

L

L

L

L

L

Low

Cioffi (2012)

Non-institutionalized subjects > 45 years of age participating in the Dysfunction in DiAbetes’ (DYDA) study recruited in 37 diabetes referral centres, Italy

61 ± 7

751 (61%)

7 (3–13)

Myocardial infarction, myocarditis, HF, coronary heart disease, alcoholic cardiomyopathy, primary hypertrophic cardiomyopathy, asymptomatic known LVD, prior myocardial revascularization, valvular heart disease, atrial fibrillation, electrocardiographic findings of myocardial ischaemia, DMI and severe systematic disease with life expectancy < 2 years

50

No

L

H

L

L

L

L

L

L

L

Low

Faden (2013)

Consecutive non-institutionalized subjects > 18 years of age attending a prospective, multicentre study, (SHORTWAVE) in cardiology and diabetes referral centres in 4 hospitals, Italy

69 ± 10

386 (57%)

5 (2–10)

Myocardial infarction, dilated cardiomyopathy or HF, primary hypertrophic cardiomyopathy, prior myocardial revascularization, valvular disease, atrial fibrillation, chronic pulmonary disease, DMI

Not reported

No

L

H

L

H

L

L

L

L

L

Medium

Dodiyi-Manuel (2013)

Patients attending the Medical Outpatient Department of the University of Port Harcourt Teaching Hospital, Nigeria

36–65 50.8 ± 9.1

180 (90 DMII patients, 43% male)

3.4 ± 2.9

Hypertension (> 140/90 mm Hg), anti-hypertensive medications, valvular abnormalities and wall motion abnormalities

55

No

L

H

H

H

L

L

L

L

L

Medium

Chen (2014)

Consecutive patients treated with stable hypoglycaemic medication for at least 3 months recruited from the medical outpatient clinic of Queen Mary Hospital, Hong Kong, China

62 ± 9

95 (39%)

10 ± 8

History or clinical symptoms of cardiovascular disease, including CAD, MI, stroke or peripheral vascular disease, renal impairment (eGFR < 30 mL/min/1.73 m2), liver failure, SLE, rheumatoid arthritis, systemic sclerosis

50

No

L

H

L

H

L

L

L

L

L

Medium

Dandamundi (2014)

Random sample of residents participating in the Rochester Epidemiology Project, Olmsted County, USA

Normal LV function: 62.6 ± 9.1

2042 (136 DMII patients, 60% male)

Not reported

Missings on systolic or diastolic assessments

50

No

L

L

L

H

L

L

L

L

L

Low

Diabetic cardiomyopathy: 68.5 ± 10.6

               

Any LV dysfunction: 67.6 ± 9.2

               

Chaudhary (2015)

Normotensive patients with newly diagnosed (within 1 month) DMII recruited from the SVBP Hospital, LLRM Medical College, Meerut, India

30–60 50.1 ± 6.3

100 (65%)

New onset

Hypertension > 130/80, abnormal ECG, already diagnosed DMII, antidiabetic treatment, valvular heart disease, ischaemic and hypertensive heart disease, congestive HF, cardiomyopathie, renal failure, COPD, severe anemia and haemoglobinopathies

50

No

L

H

H

H

L

L

L

L

L

Medium

Xanthakis (2015)

Population based longitudinal study with DM or metabolic syndrome

59.1 ± 10.46

761 (31%)

Not reported

History of CVD

50

No

L

L

L

H

L

L

L

L

L

Low

Jørgensen (2016)

Patients with DMII recruited from Sterno Diabetes Centre and the Centre for Diabetes research in Copenhagen

65.5 (58.8, 71.4)

1030 (65.9%)

11 (5.5, 17)

None

50

No

L

L

H

H

L

L

L

L

L

Medium

  1. aValues indicate the age range, mean ± standard deviation or median (range)