Systolic heart failure occurs when the heart muscle loses its ability to contract properly and therefore can’t pump forcefully enough to move blood around the body. Systolic heart failure is also known as heart failure with reduced ejection fraction (HFrEF). In diastolic heart failure, although the heart is strong enough to pump properly, it can’t fill up with blood because the heart muscle is stiff. In this case, the amount of blood pumped out to the body is reduced. Diastolic heart failure is also called heart failure with a preserved ejection fraction (HFpEF).