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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)
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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)