During these more than 20 years of evolution in understandings of the mechanisms of heart failure (HF) with preserved fractional ejection, there has been a rich variety of terminology, including „diastolic heart failure“, „heart failure with preserved systolic function“ and „heart failure with preserved fraction“. By defi nition, the latter term “ejection fraction-induced heart failure” proved to be the most appropriate and was accepted as the most correct, as the presence of diastolic dysfunction is not unique only to this group and exists in these patients, albeit subclinically and discrete disturbance in the longitudinal systolic function of the left ventricle against the background of the preserved ejection fraction. The problem, however, is not in the value of the ejection fraction or in the paradox of the combination of a well-functioning left ventricle and classic symptoms of heart failure, but in the non-infl uence of the prognosis of these patients in the way it is in patients with suppressed EF. Unlike patients with heart failure with a reduced ejection fraction, the prognosis and results in patients with HF with preserved EF do not mark the expected results and so far there are not enough effective and promising therapies.