Comparison Between HFrEF and HFpEF: Understanding Different Types of Heart Failure

Understanding Heart Failure Types: HFrEF vs HFpEF

Heart failure is a condition where the heart is unable to pump sufficient blood to meet the body's needs. It's commonly classified based on the measurement called the ejection fraction (EF), which determines how well the left ventricle pumps blood.

What is Ejection Fraction (EF)?

EF is the percentage of blood pumped out of the left ventricle with each heartbeat. Normal EF ranges from 50% to 70%.

1. Heart Failure with Reduced Ejection Fraction (HFrEF)

• Definition: EF less than 40%.
• Cause: The heart muscle weakens and cannot contract properly, leading to reduced pumping ability.
• Common Causes: Coronary artery disease, myocardial infarction (heart attack), dilated cardiomyopathy.
• Symptoms: Fatigue, shortness of breath, fluid retention causing swelling in legs, rapid heartbeat.
• Treatment: Includes ACE inhibitors, beta blockers, diuretics, lifestyle changes, and sometimes devices like defibrillators.

2. Heart Failure with Preserved Ejection Fraction (HFpEF)

• Definition: EF 50% or higher.
• Cause: The heart muscle contracts normally but is stiff during relaxation, which impairs filling of the ventricle.
• Common Causes: Hypertension, aging, diabetes, obesity, and atrial fibrillation.
• Symptoms: Similar to HFrEF – shortness of breath, fatigue, swelling – but caused by poor filling rather than poor contraction.
• Treatment: Focuses on controlling underlying conditions (e.g., blood pressure), managing symptoms, and lifestyle modifications. No specific medications are definitively proven for HFpEF.

Key Differences at a Glance:

Summary: While both HFrEF and HFpEF result in symptoms of heart failure, they differ in underlying heart function. HFrEF involves a weak heart muscle unable to pump effectively, while HFpEF involves a stiff heart muscle that does not fill properly. Understanding these differences is key for effective diagnosis and personalized treatment.