We included randomized controlled trials with parallel group or crossover designs in this meta-analysis, Study participants were type 2 diabetic patients, The outcome of the included studies must contain the following 6 cardiac function and structure measures: LVEF, LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV mass index (LVMI) and mitral inflow E velocity to tissue Doppler e′ratio (E/e′).
Information sources and search strategy
We searched articles published before September 30, 2020, regardless of language, in 4 electronic databases: PubMed, EMBASE, Cochrane Library and Web of Science. The articles were selected by manual screening
The following terms were used in the search: ventricular remodeling OR cardiac reverse remodeling OR CRR OR cardiac remodeling OR left ventricular remodeling OR left ventricular dysfunction OR LVD OR ejection fraction OR EF OR left ventricular ejection fraction OR LVEF OR end-diastolic volume OR EDV OR end-diastolic dimension OR EDD OR end-systolic volume OR ESV OR end-systolic dimension OR ESD OR LVEDD OR left ventricular end-diastolic dimension OR LVEDV OR left ventricular end-diastolic volume OR LVESD OR left ventricular end-systolic dimension OR LVESV OR left ventricular end-systolic volume OR left ventricular diameter OR left ventricular volume OR left ventricular mass index OR LVMI OR left atrial volume OR LAV OR left atrial volume index OR LAVI) AND (canagliflozin OR dapagliflozin OR empagliflozin OR ertugliflozin OR ipragliflozin OR luseogliflozin OR tofogliflozin)
Two methodologically trained independent reviewers screened titles and abstracts to determine whether they met the eligibility criteria. The reviewers read the full text and extracted relevant data after consensus was reached. Any differences were resolved through discussion and arbitration, if necessary, by a third reviewer. The reasons for inclusion or exclusion are recorded in detail. Case reports, letters and minutes of meetings were excluded.
Definition of outcomes
The outcome of this meta-analysis was the difference in the mean change in echocardiographic parameters between the treatment group and control group. The echocardiographic parameters included LVEF, LVEDV, LVESV, LVMI and E/e′.
We calculated weighted mean differences (WMDs) with 95% confidence intervals (CIs) to assess effect size for continuous variables including LVEF, LVEDV, LVESV, LVMI and E/e′. In the meta-analysis, we used a random effects model to combine estimators. We also considered a fixed effect model additionally for exploration of the discrepancy in results. The I² statistic, τ² statistic, and Cochran’s Q test were used to assess statistical heterogeneity among the studies. All statistical analyses were performed using R version 3.1.0 (R Foundation for Statistical Computing, Vienna, Austria). P values of < 0.05 was regarded as statistically significant for treatment effects and test for heterogeneity, respectively.