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heart failure is a disorder in which the heart cannot pump blood to the body at a rate that is needed causing symptoms of shortness of breath and fatigue to better understand heart failure we need to review the heartamp;#39;s function the heart has two phases during each heartbeat filling which is diastole and pumping which is systole systolic function of the heart and resulting cardiac output is governed by four major determinants these are the contractility of the myocardium the actual muscle of the heart the preload of the ventricles the amount of blood filling the ventricles prior to systole the afterload applied to the ventricles essentially what the ventricles have to overcome to push blood out of the heart and the heart rate the cardiac output equation can be simplified nicely to stroke volume which is the amount of blood the ventricles pump out during each heartbeat multiplied by heart rate which will give you the cardiac output where contractility afterload and preload all af