Left ventricular assessment using speckle-tracking echocardiography in Behçet's disease: a systematic review and meta-analysis.

Pooled LV global longitudinal strain (GLS) was not significantly reduced in Behçet's disease patients compared with healthy controls.

• Eight studies were included, comprising 373 BD patients and 402 controls.
• Pooled SMD was -0.59 (95% CI -1.21 to 0.04; p=0.06) using random-effects models.
• Studies using two- or four-dimensional STE were eligible.

In subgroup analysis, GLS impairment was more pronounced in BD patients with non-active disease.

• The SMD in non-active disease was -0.9 (95% CI -1.71 to -0.08).
• The confidence interval excludes zero, indicating a significant reduction in this subgroup.

No significant GLS difference was observed between BD patients without cardiovascular risk factors and controls.

• The subgroup of patients with no cardiovascular risk factors showed p=0.20.
• This suggests that apparent GLS differences may be related to cardiovascular risk factors rather than BD itself.

The authors concluded that BD patients do not exhibit consistent subclinical LV systolic dysfunction on strain echocardiography.

• The conclusion rests on a non-significant pooled GLS difference (p=0.06).
• Further studies are required to optimise the use of STE in this population.

Heterogeneity between studies was assessed and explored using multiple methods.

• Heterogeneity was assessed with I2 and Cochrane Q test.
• It was further explored using Baujat plot and leave-one-out analysis.
• The review was registered in PROSPERO (CRD420251251109); PubMed, Scopus and Web of Science were searched.