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Enhanced Heart Failure Management: Impact of the therapeutic unit for heart failure (TUNI-HF) on mid-term prognosis

Houdhayfa Hermassi1, Houssem Ben Ayed1, Houaida Mahfoudhi1

  • 1Department of Anaesthesia and Intensive Care, Sahloul Hospital, Sousse, Simulation Centre, Faculty of Medicine, University of Sousse, Sousse, Tunisia.

La Tunisie Medicale
|March 5, 2026
PubMed

Insights

A specialized heart failure unit improved treatment and reduced mortality and readmission rates for heart failure with reduced ejection fraction (HFrEF) patients. This dedicated care optimizes medication and device use, enhancing patient outcomes.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • Chronic heart failure (CHF) presents a significant global health challenge with high mortality and readmission rates.
  • A specialized Therapeutic Unit for Heart Failure (TUNI-HF) was established to enhance treatment, manage comorbidities, and educate patients, aiming to improve prognosis.

Purpose of the Study:

  • To evaluate the impact of the TUNI-HF on treatment optimization, mortality, and readmission rates in patients with heart failure with reduced ejection fraction (HFrEF) over 12 months.

Main Methods:

  • A retrospective study compared two groups of HFrEF patients over 12 months: a control group (Group "C") receiving usual care and an intervention group (Group "U") managed by the TUNI-HF.
  • Patient characteristics were comparable at baseline. Guideline-directed medical treatment (GDMT) prescription rates at optimal doses were assessed.

Main Results:

  • The TUNI-HF group (Group "U") showed higher prescription rates for beta-blockers (BB) and mineralocorticoid receptor antagonists (MRA) at optimal doses compared to the control group (Group "C").
  • Optimal doses of renin-angiotensin-aldosterone system inhibitors (RAASI) and MRA were more frequently achieved in Group "U". Loop diuretics were less prescribed, and cardiac implantable device implantation was higher in Group "U".
  • Kaplan-Meier analysis revealed significantly lower readmission and all-cause mortality rates in the TUNI-HF group (Group "U").

Conclusions:

  • Management within a specialized heart failure unit leads to better treatment optimization compared to usual care.
  • Specialized HF units are associated with reduced mortality and readmission rates in HFrEF patients.
Abstract

Keywords:
Heart failurePrognosisTherapeutic unit

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