Gori M, et al. - Whether diastolic dysfunction (DD) has a role in improving heart failure (HF) and death risk prediction in mild asymptomatic left ventricular systolic dysfunction (ALVSD) was investigated in 623 asymptomatic outpatients at increased risk for HF prospectively enrolled in the DAVID-Berg study. Excluding subjects with left ventricular ejection fraction (LVEF) <40% or without full echocardiographic data, researchers divided subjects into control group (normal LVEF, n = 459, 76%), mild ALVSD (LVEF ≥40%/<53%) without DD (n = 89, 15%) and with DD (n = 54, 9%). A higher risk of incident HF/death was seen in relation to mild ALVSD vs the control group. However, only subjects with combined DD had this higher risk. An echocardiographic exam was usually done to evaluate systolic dysfunction in a high-risk population. Findings highlighted the importance of also depending on DD to risk stratify mild ALVSD. Mainly in subjects with combined DD, adverse events might be predicted by mild ALVSD.