What does systolic heart failure primarily reflect?

Systolic heart failure primarily reflects the heart's inability to contract effectively, leading to a decrease in cardiac output. In this condition, the left ventricle becomes weakened and cannot pump blood efficiently during systole, which is the phase of the heartbeat when the heart muscles contract and push blood out of the heart. This results in insufficient blood flow to meet the body's demands, ultimately causing symptoms such as fatigue, shortness of breath, and fluid retention.

The decreased ability to contract is often due to myocardial damage, which can occur from conditions such as myocardial infarction, chronic hypertension, or cardiomyopathy. This impaired contractility often results in a lowered ejection fraction, defined as the percentage of blood volume that the heart pumps with each contraction. In systolic heart failure, the ejection fraction is typically below normal levels, confirming the heart's compromised capability to effectively manage blood circulation.