Because reduced EF entails systolic and diastolic impairment, HFrEF is clearer and more accurate than systolic heart failure, which can mislead by overemphasizing systolic dysfunction.
Amboss Heart Failure Article
https://next.amboss.com/us/article/rS0faf?q=heart%20failure#Y528fec3c4828384b59f34c68cd452cf3
Amboss states in the its heart failure article under Historical Terminology -- "Systolic HF has been used as a synonym for HF with reduced ejection fraction (HFrEF) but is no longer favored because individuals with HFrEF have both systolic and diastolic dysfunction."
I added this explanation in the extra section as well for clarity.
Despite the fact that the image in extra already clarifies it at the bottom, this would replace the info already in the extra section stating that HFrEF and systolic heart failure are the same.
I don't know if this would be considered a "random article" per the change submission rules but this journal from JACC talks about diastolic dysfunction in relation to HFeRF and HFpRF stating "In most patients with HF, abnormalities of systolic and diastolic dysfunction coexist, regardless of EF"
This corroborates the reasoning that Amboss gave for using HFrEF.
Journal Link: https://www.jacc.org/doi/10.1016/j.jchf.2019.06.005
Additionally, FA 2025 page 316 (Cardio > Path) mentions the fact that HFrEF is predominately associated with systolic dysfunction but does not refer to it as systolic heart failure just HFrEF -- "Systolic dysfunction—heart failure with reduced ejection fraction (HFrEF)"
Source: AMBOSS - https://next.amboss.com/us/article/rS0faf?q=heart%20failure#Y528fec3c4828384b59f34c68cd452cf3
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