581 patients with chronic heart failure (CHF) of ischemic origin with systolic left ventricular dysfunction (SLVD) and preserved left ventricular ejection fraction (PLVEF) were examined. This study was aimed at comparing myocardial structure and function indicators and autonomic regulation of heart rhythm in patients with CHF with SLVD and with PLVEF. Compared to patients with CHF and SLVD, patients with CHF and PLVEF are characterized by smaller sizes of left atrium, end-diastolic volume index, end-systolic volume index and lower left ventricular myocardial mass index. Significantly higher values of relative left ventricular wall thickness and the ratio myocardial mass to end-diastolic volume were observed in patients with PLVEF, what corresponds to twice high frequency (72 vs 37%) of the concentric hypertrophy cases. Persons with impaired relaxation type (46%) predominate among patients with PLVEF, while patients with pseudonormal (34%) and restrictive (35%) types of the transmitral flow predominate among patients with SLVD. Compared to patients with symptomatic SLVD, patients with CHF and PLVEF are characterized by higher heart rate variability indicators and better sensitivity to sympathetic effects.