{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T14:56:24Z","timestamp":1782917784567,"version":"3.54.5"},"reference-count":50,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"\u201cVictor Babes\u201d University of Medicine and Pharmacy"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Type 2 diabetes mellitus (T2DM) is associated with subclinical myocardial dysfunction, which may occur despite preserved left ventricular ejection fraction. Left ventricular global longitudinal strain (LV GLS) is a sensitive marker of early systolic impairment and may detect subtle changes in myocardial function before conventional echocardiographic parameters become abnormal. The effect of sodium-glucose cotransporter-2 inhibitors (SGLT2i) on LV GLS in adults with T2DM remains incompletely defined. Objective: To synthesize the available evidence on the effects of SGLT2i therapy on LV GLS or LV strain in adults with T2DM. Methods: Original full-text human studies evaluating SGLT2i therapy in adults with T2DM and reporting LV GLS or LV strain were included. LV GLS was assessed primarily by speckle-tracking echocardiography, while one study used cardiac magnetic resonance feature-tracking. Reviews, conference abstracts, protocols, animal-only studies, and studies without LV strain assessment were excluded. Risk of bias was assessed using RoB 2 for randomized studies and ROBINS-I for non-randomized studies. Results: Twenty-six studies involving more than 2300 participants were included. The studies evaluated dapagliflozin, empagliflozin, ertugliflozin, canagliflozin, or mixed SGLT2i regimens across heterogeneous clinical populations, including patients with preserved ejection fraction, pre-heart failure, diabetes-related cardiomyopathy, chronic heart failure, coronary artery disease, hypertension, non-alcoholic fatty liver disease, and cardio-oncology risk. Most observational and before\u2013after studies reported favorable changes in LV GLS after SGLT2i therapy, whereas randomized and controlled studies showed more variable findings. Several studies also reported improvements in LV remodeling, diastolic function, left atrial function, myocardial work indices, NT-proBNP, cardiometabolic parameters, or epicardial adipose tissue thickness. However, the certainty of evidence was limited by methodological heterogeneity, differences in comparator groups, variable follow-up duration, non-standardized imaging protocols, and risk of bias, particularly in non-randomized and single-arm studies. Conclusions: SGLT2i therapy may be associated with favorable changes in LV GLS in adults with T2DM, suggesting a potential beneficial effect on subclinical left ventricular systolic function. However, current evidence does not definitively establish a consistent treatment effect across all populations. Larger randomized controlled trials with standardized strain imaging protocols, predefined LV GLS endpoints, and clinically relevant follow-up are needed to determine whether SGLT2i-related improvements in LV GLS reflect true myocardial benefit and translate into improved cardiovascular outcomes.<\/jats:p>","DOI":"10.3390\/jcm15135137","type":"journal-article","created":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T12:41:38Z","timestamp":1782909698000},"page":"5137","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Sodium-Glucose Cotransporter-2 Inhibitors on Left Ventricular Global Longitudinal Strain in Adults with Type 2 Diabetes Mellitus: A Systematic Review"],"prefix":"10.3390","volume":"15","author":[{"given":"Larissa","family":"D\u0103niluc","sequence":"first","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cPius Brinzeu\u201d Clinical Emergency County Hospital Timisoara, 300736 Timisoara, Romania"},{"name":"Discipline of Cardiology, Department VII, Internal Medicine II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u0103zvan","family":"D\u0103niluc","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6305-705X","authenticated-orcid":false,"given":"Adela","family":"Benea","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Clinical Hospital of Infectious Diseases and Pulmonology \u201cVictor Babes\u201d, Gheorghe Adam Street 13, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1330-8191","authenticated-orcid":false,"given":"Alexandra-Iulia","family":"Laz\u0103r-H\u00f6cher","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Research Center, Institute of Cardiovascular Diseases Timisoara, 300310 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-3870-6986","authenticated-orcid":false,"given":"Claudia Raluca Balasa","family":"Virzob","sequence":"additional","affiliation":[{"name":"Department of Clinic Nursing, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7487-4639","authenticated-orcid":false,"given":"Mihaela-Diana","family":"Popa","sequence":"additional","affiliation":[{"name":"Department of Microbiology, \u201cVictor Babes\u201d University of Medicine and Pharmacy Timisoara, Eftimie Murgu Square 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3531-3974","authenticated-orcid":false,"given":"Razvan","family":"Susan","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Centre for Preventive Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7904-6073","authenticated-orcid":false,"given":"Adina","family":"Braha","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Center for Molecular Research in Nephrology and Vascular Disease, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6684-1759","authenticated-orcid":false,"given":"Adrian","family":"Apostol","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cPius Brinzeu\u201d Clinical Emergency County Hospital Timisoara, 300736 Timisoara, Romania"},{"name":"Discipline of Cardiology, Department VII, Internal Medicine II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9042-9924","authenticated-orcid":false,"given":"Alexandra","family":"Sima","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lina Haj","family":"Ali","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cPius Brinzeu\u201d Clinical Emergency County Hospital Timisoara, 300736 Timisoara, Romania"},{"name":"Discipline of Cardiology, Department VII, Internal Medicine II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9586-6080","authenticated-orcid":false,"given":"Loredana","family":"Suhov","sequence":"additional","affiliation":[{"name":"Doctoral School, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"},{"name":"Department of Cardiology, \u201cPius Brinzeu\u201d Clinical Emergency County Hospital Timisoara, 300736 Timisoara, Romania"},{"name":"Discipline of Cardiology, Department VII, Internal Medicine II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1335-6845","authenticated-orcid":false,"given":"Delia","family":"Hutanu","sequence":"additional","affiliation":[{"name":"Biology Department, Chemistry-Biology-Geography Faculty, West University of Timisoara, 300115 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4304-4911","authenticated-orcid":false,"given":"Mihaela Viviana","family":"Ivan","sequence":"additional","affiliation":[{"name":"Department of Cardiology, \u201cPius Brinzeu\u201d Clinical Emergency County Hospital Timisoara, 300736 Timisoara, Romania"},{"name":"Discipline of Cardiology, Department VII, Internal Medicine II, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"American Diabetes Association Professional Practice Committee (2025). 10. Cardiovascular disease and risk management: Standards of Care in Diabetes\u20142025. Diabetes Care, 48, S207\u2013S238.","DOI":"10.2337\/dc25-S010"},{"key":"ref_2","unstructured":"International Diabetes Federation (2025). IDF Diabetes Atlas, International Diabetes Federation. [11th ed.]. Available online: https:\/\/diabetesatlas.org\/resources\/idf-diabetes-atlas-2025\/."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"574","DOI":"10.1007\/s00125-023-06068-2","article-title":"Epidemiology of heart failure in diabetes: A disease in disguise","volume":"67","author":"Hoek","year":"2024","journal-title":"Diabetologia"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"S\u0142awi\u0144ski, G., Hawryszko, M., Li\u017cewska-Springer, A., Nabia\u0142ek-Trojanowska, I., and Lewicka, E. (2023). Global longitudinal strain in cardio-oncology: A review. Cancers, 15.","DOI":"10.3390\/cancers15030986"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Antoniou, N., Iliopoulou, S., Raptis, D.G., Grammenos, O., Kalaitzoglou, M., Chrysikou, M., Mantzios, C., Theodorou, P., Bostanitis, I., and Charisopoulou, D. (2025). Global longitudinal strain in stress echocardiography: A review of its diagnostic and prognostic role in noninvasive cardiac assessment. Diagnostics, 15.","DOI":"10.3390\/diagnostics15162076"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"260","DOI":"10.1016\/j.jcmg.2017.11.017","article-title":"Assessment of left ventricular function by echocardiography: The case for routinely adding global longitudinal strain to ejection fraction","volume":"11","author":"Potter","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Nghiem, T.P., Tran, H.M., Nguyen, D.N.Q., Dao, L.T., Tran, C.C., and Vo, T.M. (2025). Subclinical myocardial dysfunction in type 2 diabetes mellitus with preserved ejection fraction. Med. Sci., 13.","DOI":"10.3390\/medsci13040237"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1892","DOI":"10.1016\/j.amjcard.2019.06.011","article-title":"Defining subclinical myocardial dysfunction and implications for patients with diabetes mellitus and preserved ejection fraction","volume":"124","author":"Ng","year":"2019","journal-title":"Am. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1504720","article-title":"Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes","volume":"373","author":"Zinman","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1056\/NEJMoa1911303","article-title":"Dapagliflozin in patients with heart failure and reduced ejection fraction","volume":"381","author":"McMurray","year":"2019","journal-title":"N. Engl. J. Med."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Gamaza-Chuli\u00e1n, S., D\u00edaz-Retamino, E., Gonz\u00e1lez-Test\u00f3n, F., Gaitero, J.C., Castillo, M.J., Alfaro, R., Rodr\u00edguez, E., Gonz\u00e1lez-Caballero, E., and Mart\u00edn-Santana, A. (2021). Effect of sodium-glucose cotransporter 2 (SGLT2) inhibitors on left ventricular remodelling and longitudinal strain: A prospective observational study. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-02250-9"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"108509","DOI":"10.1016\/j.jdiacomp.2023.108509","article-title":"Echocardiographic evaluation of the effect of dapagliflozin on epicardial adipose tissue and left ventricular systolic function in type 2 diabetes mellitus","volume":"37","author":"Song","year":"2023","journal-title":"J. Diabetes Its Complicat."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1186\/s12933-024-02463-0","article-title":"Effect of ertugliflozin on left ventricular function in type 2 diabetes and pre-heart failure: The Ertu-GLS randomized clinical trial","volume":"23","author":"Lim","year":"2024","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"232","DOI":"10.1186\/s12933-025-02796-4","article-title":"Effects of dapagliflozin on the progression of left ventricular dysfunction in type 2 diabetes mellitus: A randomized controlled trial","volume":"24","author":"Marwick","year":"2025","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Oka, S., Kai, T., Hoshino, K., Watanabe, K., Nakamura, J., Abe, M., and Watanabe, A. (2021). Effects of empagliflozin in different phases of diabetes mellitus-related cardiomyopathy: A prospective observational study. BMC Cardiovasc. Disord., 21.","DOI":"10.1186\/s12872-021-02024-3"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1186\/s12933-019-0985-z","article-title":"Positive effect of dapagliflozin on left ventricular longitudinal function for type 2 diabetic mellitus patients with chronic heart failure","volume":"19","author":"Tanaka","year":"2020","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"517","DOI":"10.1007\/s10554-020-02034-w","article-title":"Empagliflozin and left ventricular diastolic function following an acute coronary syndrome in patients with type 2 diabetes","volume":"37","author":"Lan","year":"2021","journal-title":"Int. J. Cardiovasc. Imaging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1832","DOI":"10.1016\/j.jcmg.2022.05.019","article-title":"Impact of empagliflozin on left ventricular strain: Insights from the EMPA-HEART CardioLink-6 randomized clinical trial","volume":"15","author":"Moses","year":"2022","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"110686","DOI":"10.1016\/j.diabres.2023.110686","article-title":"Impact of gliflozins on cardiac remodeling in patients with type 2 diabetes mellitus and reduced ejection fraction heart failure: A pilot prospective study. GLISCAR study","volume":"200","author":"Palmiero","year":"2023","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_21","first-page":"4121","article-title":"The effects of SGLT-2 inhibitors on echocardiographic indices and antioxidative properties in patients with heart failure with reduced ejection fraction and diabetes mellitus","volume":"28","author":"Duzen","year":"2024","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"113147","DOI":"10.1016\/j.diabres.2026.113147","article-title":"SGLT2 inhibitors improve subclinical left ventricular systolic function independent of body mass index in patients with type 2 diabetes: A prospective strain imaging study","volume":"233","author":"Polat","year":"2026","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Ozturk, H.A., Koc, M., Okyay, R.A., Ozturk, D.D., Gulumsek, E., Buyuksimsek, M., Turker, M., Cetin, A.E., Arici, F.N., and Sumbul, H.E. (2026). Cardioprotective effects of dapagliflozin against doxorubicin-induced cardiotoxicity in breast cancer patients with type 2 diabetes: A prospective study. BMC Cancer, 26.","DOI":"10.1186\/s12885-026-15696-x"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"262","DOI":"10.2337\/db20-0840","article-title":"Dapagliflozin suppresses ER stress and improves subclinical myocardial function in diabetes: From bedside to bench","volume":"70","author":"Shih","year":"2021","journal-title":"Diabetes"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"107590","DOI":"10.1016\/j.jdiacomp.2020.107590","article-title":"Effect of dapagliflozin on cardiac function in people with type 2 diabetes and albuminuria: A double blind randomized placebo-controlled crossover trial","volume":"34","author":"Eickhoff","year":"2020","journal-title":"J. Diabetes Complicat."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1111\/echo.15424","article-title":"Effects of 3 months of treatment with empagliflozin on left ventricle global longitudinal strain and myocardial mechano-energetic efficiency","volume":"39","author":"Dural","year":"2022","journal-title":"Echocardiography"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Cort\u00e9s, M., Lorenzo, O., Lumpuy-Castillo, J., Mart\u00ednez-Albaladejo, S., Taibo-Urqu\u00eda, M., Pello, A.M., Egido, J., G\u00f3mez-Guerrero, C., Moreno, J.A., and Ortiz, A. (2023). Dapagliflozin improved cardiac function and structure in diabetic patients with preserved ejection fraction: Results of a single centre, observational prospective study. J. Clin. Med., 12.","DOI":"10.3390\/jcm12206698"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1186\/s12933-022-01618-1","article-title":"Effect of empagliflozin on left ventricular contractility and peak oxygen uptake in subjects with type 2 diabetes without heart disease: Results of the EMPA-HEART trial","volume":"21","author":"Nesti","year":"2022","journal-title":"Cardiovasc. Diabetol."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Attaran, F., Emami, S., Sohrabi, M., Malek, M., Ajdarkosh, H., Khoonsari, M., Ismail-Beigi, F., and Khamseh, M.E. (2023). Effect of empagliflozin and pioglitazone on left ventricular function in patients with type two diabetes and nonalcoholic fatty liver disease without established cardiovascular disease: A randomized single-blind clinical trial. BMC Gastroenterol., 23.","DOI":"10.1186\/s12876-023-02948-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"21327","DOI":"10.1038\/s41598-023-48716-y","article-title":"Effects of canagliflozin on cardiac remodeling and hemodynamic parameters in patients with type 2 diabetes mellitus","volume":"13","author":"Kuo","year":"2023","journal-title":"Sci. Rep."},{"key":"ref_31","first-page":"101329","article-title":"Impact of sodium glucose co-transporter-2 inhibitors on left atrial functions in patients with type-2 diabetes and heart failure with mildly reduced ejection fraction","volume":"50","year":"2024","journal-title":"Int. J. Cardiol. Heart Vasc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1111\/jdi.14199","article-title":"Improvements of myocardial strain and work in diabetes patients with normal ejection fraction after empagliflozin treatment","volume":"15","author":"Cheng","year":"2024","journal-title":"J. Diabetes Investig."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e033832","DOI":"10.1161\/JAHA.123.033832","article-title":"Dapagliflozin add-on therapy improves cardiac remodeling and mechanical function in asymptomatic type 2 diabetes: ELUCIDATE trial: A single-center randomized controlled study","volume":"13","author":"Lin","year":"2024","journal-title":"J. Am. Heart Assoc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"640","DOI":"10.33963\/v.phj.100613","article-title":"The impact of using SGLT-2 inhibitor on left ventricular longitudinal strain and NT-proBNP levels during six-month follow-up in diabetic patients with and without coronary artery disease with preserved ejection fraction","volume":"82","author":"Biter","year":"2024","journal-title":"Pol. Heart J."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"448","DOI":"10.4330\/wjc.v16.i8.448","article-title":"Sodium-dependent glucose transporter 2 inhibitors effects on myocardial function in patients with type 2 diabetes and asymptomatic heart failure","volume":"16","year":"2024","journal-title":"World J. Cardiol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"5111","DOI":"10.1038\/s41598-025-89459-2","article-title":"The protective effect of sodium-glucose cotransporter-2 inhibitor on left ventricular global longitudinal strain in patients with type 2 diabetes mellitus according to disease duration","volume":"15","author":"Wang","year":"2025","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"388","DOI":"10.5505\/ejm.2025.04378","article-title":"The effect of empagliflozin on cardiac systolic and diastolic functions in patients with type 2 diabetes mellitus and hypertension","volume":"30","author":"Karaduman","year":"2025","journal-title":"East J. Med."},{"key":"ref_38","doi-asserted-by":"crossref","unstructured":"Pavlidis, G., Prentza, V., Ikonomidis, I., Katogiannis, K., Kountouri, A., Thymis, J., Michalopoulou, E., Pliouta, L., Korakas, E., and Stefanou, M.-I. (2026). Vascular and myocardial function in patients with type 2 diabetes and ischemic stroke treated with dulaglutide or empagliflozin. Medicina, 62.","DOI":"10.3390\/medicina62020254"},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Korakas, E., Thymis, J., Oikonomou, E., Mourouzis, K., Kountouri, A., Pliouta, L., Michalopoulou, E., Katogiannis, K., Pavlidis, G., and Ikonomidis, I. (2024). Dulaglutide and dapagliflozin combination concurrently improves the endothelial glycocalyx and vascular and myocardial function in patients with T2DM and albuminuria vs. DPP-4i. J. Clin. Med., 13.","DOI":"10.3390\/jcm13247497"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Katogiannis, K., Ikonomidis, I., Pavlidis, G., Kountouri, A., Thymis, J., Pliouta, L., Michalopoulou, E., Korakas, E., Mourouzis, K., and Lambadiari, V. (2024). Effects of liraglutide, empagliflozin and their combination on left atrial strain and arterial function. Medicina, 60.","DOI":"10.3390\/medicina60030395"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"e039129","DOI":"10.1161\/JAHA.124.039129","article-title":"Effects of glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and their combination on neurohumoral and mitochondrial activation in patients with diabetes","volume":"14","author":"Ikonomidis","year":"2025","journal-title":"J. Am. Heart Assoc."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"e015716","DOI":"10.1161\/JAHA.119.015716","article-title":"Effects of glucagon-like peptide-1 receptor agonists, sodium-glucose cotransporter-2 inhibitors, and their combination on endothelial glycocalyx, arterial function, and myocardial work index in patients with type 2 diabetes mellitus after 12-month treatment","volume":"9","author":"Ikonomidis","year":"2020","journal-title":"J. Am. Heart Assoc."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"443","DOI":"10.1038\/s41569-022-00824-4","article-title":"SGLT2 inhibitors: Role in protective reprogramming of cardiac nutrient transport and metabolism","volume":"20","author":"Packer","year":"2023","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"233","DOI":"10.1093\/ehjci\/jev014","article-title":"Recommendations for cardiac chamber quantification by echocardiography in adults: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"16","author":"Lang","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1093\/ehjci\/jew082","article-title":"Recommendations for the evaluation of left ventricular diastolic function by echocardiography: An update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging","volume":"17","author":"Nagueh","year":"2016","journal-title":"Eur. Heart J. Cardiovasc. Imaging"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1093\/eurheartj\/ehs016","article-title":"A novel clinical method for quantification of regional left ventricular pressure-strain loop area: A non-invasive index of myocardial work","volume":"33","author":"Russell","year":"2012","journal-title":"Eur. Heart J."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1038\/oby.2003.45","article-title":"Epicardial fat from echocardiography: A new method for visceral adipose tissue prediction","volume":"11","author":"Iacobellis","year":"2003","journal-title":"Obes. Res."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"l4898","DOI":"10.1136\/bmj.l4898","article-title":"RoB 2: A revised tool for assessing risk of bias in randomised trials","volume":"366","author":"Sterne","year":"2019","journal-title":"BMJ"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"i4919","DOI":"10.1136\/bmj.i4919","article-title":"ROBINS-I: A tool for assessing risk of bias in non-randomised studies of interventions","volume":"355","author":"Sterne","year":"2016","journal-title":"BMJ"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ehjci\/jeu184","article-title":"Definitions for a common standard for 2D speckle tracking echocardiography: Consensus document of the EACVI\/ASE\/Industry Task Force to standardize deformation imaging","volume":"16","author":"Voigt","year":"2015","journal-title":"Eur. Heart J. Cardiovasc. 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