Although cardiac involvement such as pericarditis, myocarditis, coronary arteritis and valvular disease in Behcet's disease occurs, few studies have assessed left ventricular diastolic function. This study assesses the prevalence of both systolic and diastolic left ventricular dysfunction in patients with Behcet's disease who have no clinical cardiac manifestations. Twenty-two patients (12 women and 10 men, mean age 34 +/- 2.4 years) underwent full clinical examination, electrocardiography, M-mode, two-dimensional, and Doppler echocardiography. The mean disease duration was 5 +/- 4.7 years (range, 1 month-16 years). An age and sex-matched control group of 20 healthy subjects was also studied. Prolonged isovolumic relaxation time, prolonged deceleration time, reversal of the early and late peak transmitral diastolic flow velocities, late peak transmitral diastolic flow velocities (E/A ratio) and increased atrial filling fraction were noted in five patients. It is concluded that left ventricular dysfunction occurs frequently in patients with Behcet's disease and Doppler echocardiography may be valuable in detecting diastolic filling abnormalities as an early sign of cardiac involvement.