Systolic dysfunction means that there is a contractility issue.
Diastolic dysfunction means that the problem is not emptying the heart but rather filling the heart because of increased stiffness of the left ventricular wall. The situation is actually becoming more complicated than that and we are now starting to identify patients who have both systolic and diastolic dysfunction and that can be difficult to sort out at times. The distinction is important because the treatment is different for systolic and diastolic dysfunction. One of the pleas I make to the housestaff when I am acting as attending physician on the wards is to recognize that CHF is really not a diagnosis but rather a symptom, a manifestation. We need to track down the etiology.