Heart failure represents a major public health problem worldwide with high rates of mortality and morbidity. The same issue can be observed in France, with regional disparities. Reunion is particularly affected.

This study was intended to highlight epidemiological characteristics of heart failure in Reunion and to demonstrate expected benefits of close and regular follow-up in day unit by a multidisciplinary team.

In this retrospective observational study, adults with chronic heart failure with reduced ejection fraction less than 40% were followed at-least three months in day unit. Epidemiological characteristics specific to Reunion were explored comparing data from literature. To demonstrate benefits of unit day, the primary outcome was improvement of left ventricular ejection fraction (LVEF) of 10% and/or beyond to 45%.

Forty patients of which 75% were Creole people were followed during 11.9±7.1 months. The average age was 54.5±16.3 years old. 30% of patient was less than 45 years old. At baseline, the average LVEF was 28.9±8.3%. According to guidelines, 92.5% of patients had optimal medical therapy at final of follow-up. 50% of patients had significant improvement of LVEF during follow-up. Rehospitalization rate was 12.5% and survival rate was 97.5%. Age (P=0.04), comorbidities (P=0.04), NTproBNP level (P=0.01) at baseline and the support within the unit from acute phase (P<0.01) were predicting factors of improved LVEF in univariate analysis.

Heart failure day unit seems to be beneficial, especially in Reunion island where chronic heart failure is devastating in particularly young adults. Its development must continue, specifying characteristics of eligible patients and timing of this intervention.