Table 1.

SGLT2 inhibitors, left ventricular diastolic function and HFpEF

Reference	Sample size	Medication	Follow-up period	Main findings
Verma et al. [18]	10 DM patients with normal LVEF	Empagliflozin	3 months	Significant reduction in LV mass index and improved LV diastolic function (↑e′)
Cohen et al. [19]	20 DM patients with normal LVEF	Empagliflozin	6 months	Reduction in LVEDV without differences in measures of LV mass, LVEF and cardiac fibrosis
Rau et al. [20]	42 DM patients with preserved LVEF (≈50%)	Empagliflozin	3 months	Significantly improved LV diastolic function by reduction of E/e′, but did not change LV longitudinal strain
Lan et al. [21]	44 DM patients after ACS	Empagliflozin	6 months	Reduction in LV mass index, LA volume index and increase in E/e′, withount change in LV longitudinal strain and LVEF
Eickhoff et al. [22]	36 DM with normal LVEF	Dapagliflozin	12 weeks	Dapagliflozin did not have effect on LVEF, LV mass index and E/e′. The composite score showed LV diastolic function improvement of 19.8%
Zhang et al. [17]	4790 DM patients (meta-analysis)	Dapagliflozin Empagliflozin Tofogliflozin	-	SGLT-2 inhibitors are more significantly related with improved LVEDD and E/e′
Hwang et al. [23]	202 DM patients with HFpEF, HFrEF and without HF	Dapagliflozin Empagliflozin Impragliflozin	13 months	Significant decrease in LVEDD, improvement in LVEF, reduction in LV mass index, and E/e′ in HF patients. The improvements were more prominent in HF patients than those without HF, and in HFrEF patients than HFpEF patients
Shim et al. [24]	60 DM patients with LV diastolic dysfunction	Dapagliflozin	24 weeks	Dapagliflozin did not significantly affect resting e′ velocity, E/e′, LV mass index, and left atrial volume index, but it significantly improved E/e′ during exercise, which reduced symptoms during effort
Matsutani et al. [25]	38 DM patients with normal LVEF	Canagliflozin	3 months	LV diastolic function (E/e′) was significantly improved after canagliflozin usage
Otagaki et al. [26]	26 DM patients with normal LVEF	Tofogliflozin	6 months	Significantly improved LVEF and increased E/e′
Soga et al. [27]	58 patients with stable HFrEF	Dapagliflozin	6 months	E/e′ significantly decreased, as well as LA volume index and LV mass index significantly decreased
Tanaka et al. [28]	53 DM patients with stable HFpEF	Dapagliflozin	6 months	Dapagliflozin was found to be associated with improvement of LV longitudinal myocardial strain, which induced further improvement of LV diastolic function of DM patients with stable HFpEF
Sezai et al. [29]	35 DM patients with stable HFpEF	Canagliflozin	12 months	Improved LV diastolic function

ACS acute coronary syndrome DM diabetes mellitus HF heart failure HFpEF heart failure with preserved ejection fraction HFrEF heart failure with reduced ejection fraction LA left atrium LV left ventricle LVEF left ventricular ejection fraction SGLT2 sodium-glucose co-transporter 2 inhibitors