What's Heart Failure with Preserved Ejection Fraction (HFpEF)? Heart failure is a condition in which the guts muscle is unable to pump sufficient blood to fulfill the body’s nutrition and oxygen wants. We classify heart failure based on which of those two functions is abnormal. If the center muscle is just too weak, the condition is called coronary heart failure with a decreased ejection fraction (HFrEF). Ejection fraction is used to assess the pump operate of the guts