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Unmasking High-Output Heart Failure: Beyond Conventional Paradigms
Irfan Shafi1, Khaled M Harmouch2, Preeya Prakash1
1From the Department of Internal Medicine, Division of Cardiology, Wayne State University, Detroit, MI.
Cardiology in Review
|January 14, 2025
Summary
High-output heart failure (HOHF) is a distinct condition with elevated cardiac output. Understanding its unique pathophysiology is crucial for accurate diagnosis and effective management, differentiating it from other heart failure types.
Area of Science:
- Cardiology
- Internal Medicine
Background:
- Heart failure (HF) is a major health concern affecting millions.
- High-output heart failure (HOHF) is a specific subtype characterized by elevated cardiac output (>8 L/min or CI >4 L/min/m²).
- HOHF shares clinical presentations with other HF types but has distinct pathophysiology.
Purpose of the Study:
- To provide a comprehensive review of HOHF, including its definition, etiopathology, and pathophysiology.
- To highlight the clinical importance and under-recognition of HOHF.
- To propose a novel diagnostic algorithm for HOHF.
Main Methods:
- Literature review and analysis of existing knowledge on HOHF.
- Exploration of pathophysiological mechanisms driving HOHF.
- Development of a diagnostic algorithm based on identified challenges.
Main Results:
- HOHF results from a progressive decline in systemic vascular resistance, leading to elevated cardiac output and left ventricular remodeling.
- Misdiagnosis of HOHF can lead to inappropriate treatment, particularly with vasodilators.
- Current literature and clinical recognition of HOHF are limited.
Conclusions:
- Accurate differentiation of HOHF is essential for appropriate patient management.
- A novel diagnostic algorithm is proposed to aid in identifying HOHF.
- Further research and clinical awareness are needed for HOHF.
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