Fig. 1: PRISMA flow chart of study selection process.

a The systematic search in SCOPUS and PubMed of the 6th of July 2022, yielded 2606 unique publications. After title and abstract screening, and full-text assessment 2535 articles were excluded based on the exclusion criteria, and 71 were included. b The systematic search in SCOPUS and PubMed of the 28th of June 2024, yielded 265 new unique publications. After title and abstract screening, and full-test screening, an additional 17 studies were included. Data from 88 articles (see Supplementary Reference List) were extracted and included in downstream meta-analysis. c Meta-analyses were performed for the effect of ECM treatment on our primary outcomes (Left Ventricular Ejection Fraction – LVEF, 67 studies; Animal Survival, 21 studies) and secondary outcomes (Infarct size, 59 studies; Fractional Shortening, 43 studies; Stroke Volume, 14 studies; Wall Thickness, 32 studies).