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Heart Failure its simply the heart can not perform its function properly at the end of the filling period (diastolic period) we have the end-diastolic volume (EDV) in the left ventricle, which is also called the pre-load, after that pumping will start ejecting the blood, and that is the systole and at the end of the systolic period we still have some blood stay in the ventricle because not all blood will be ejected by systole, some of blood will stay between the papillary muscle and the wall of the left ventricle and those of the right ventricle and this volume will be the end-systolic volume (ESV), the difference between these two volumes is the stroke volume (cardiac output).  now if we dived the stroke volume by EDV we will be able to know how much of the EDV will be ejected and this is called the Ejection Fraction (E.F.) E.F. is the ratio between the stroke volume and the EDV normally must be over 50%.  when the E.F. is less than 50% this sign of heart faliure ...