From the Guidelines
High output cardiac failure is not the same as heart failure with preserved ejection fraction (HFpEF), as they have distinct underlying mechanisms and management strategies. High output cardiac failure occurs when the heart pumps an increased volume of blood but cannot meet the body's excessive demands, despite a normal or elevated cardiac output, with common causes including anemia, hyperthyroidism, arteriovenous fistulas, beriberi, and pregnancy 1. In contrast, HFpEF (previously called diastolic heart failure) occurs when the heart's left ventricle cannot relax properly between beats, leading to inadequate filling despite maintaining a normal ejection fraction (typically ≥50%), and is often associated with hypertension, aging, obesity, and diabetes 1.
Key Differences
- High output cardiac failure is characterized by an increased cardiac output, whereas HFpEF is characterized by a normal or near-normal left ventricular ejection fraction (LVEF) with raised LV filling pressures at rest or on exertion 1.
- The treatment approaches for high output cardiac failure and HFpEF differ significantly, with high output failure focusing on addressing the underlying cause and HFpEF management typically involving controlling blood pressure, using diuretics for fluid overload, and addressing cardiovascular risk factors 1.
- Both conditions can present with similar symptoms of heart failure, including shortness of breath, fatigue, and fluid retention, but their pathophysiology and management strategies are fundamentally different.
Management Strategies
- High output cardiac failure management involves addressing the underlying cause, such as treating anemia or managing hyperthyroidism.
- HFpEF management involves controlling blood pressure, using diuretics for fluid overload, and addressing cardiovascular risk factors, with recent advances in therapy including the use of sodium-glucose co-transporter 2 (SGLT2) inhibitors to reduce composite of cardiovascular death or HF hospitalizations 1.
Clinical Implications
- Accurate diagnosis and timely implementation of guideline-directed medical therapy (GDMT) are crucial for improving outcomes in HFpEF patients 1.
- Recognizing sex-specific differences in diagnosis and care management is also important for optimizing treatment strategies 1.
From the Research
Definition and Classification
- Heart Failure with preserved ejection fraction (HFpEF) is defined as heart failure with a preserved ejection fraction, typically greater than or equal to 50% 2, 3, 4, 5, 6.
- HFpEF is a type of heart failure where the heart's ejection fraction is normal, but the heart is still unable to meet the body's needs 2, 3, 4, 5, 6.
Comparison to High Output Cardiac Failure
- There is no direct mention of "high output cardiac failure" being the same as HFpEF in the provided studies 2, 3, 4, 5, 6.
- High output cardiac failure typically refers to a condition where the heart is pumping more blood than normal, often due to conditions such as severe anemia, thyrotoxicosis, or beriberi 2, 3, 4, 5, 6 do not provide information on this topic.
- The provided studies focus on HFpEF, its mechanisms, diagnosis, and treatment, but do not discuss high output cardiac failure in relation to HFpEF 2, 3, 4, 5, 6.
Key Differences
- HFpEF is characterized by a preserved ejection fraction, whereas high output cardiac failure is typically associated with an increased cardiac output 2, 3, 4, 5, 6 do not provide a direct comparison.
- The pathophysiology and treatment strategies for HFpEF and high output cardiac failure are likely to be different, given their distinct characteristics 2, 3, 4, 5, 6 do not provide information on high output cardiac failure.