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अमूर्त

Heart Failure with Improved Ejection Fraction (HFiEF) in Afro Caribbean Population: Fact or Fiction? A Case Series and Review of the Literature

Felix Nunura*, Edwin Tulloch-Reid, Dainia S. Baugh, Ernest C Madu

Background The group of Afro-Caribbean patients with HFrEF who experience improvement of LVEF to nearly normal or even normal levels (HFiEF) after Guideline-Directed Medical Therapy (GDMT) including ARNI (Sacubitril/Valsartan) represents a unique cohort of HF patients that has not been previously documented. Methods Case series, observational study of Afro-Caribbean outpatients with HFrEF from the Heart Institute of the Caribbean (Jamaica) that were treated with ARNI in addition of conventional GDMT (Beta Blockers, MRA). Clinical characteristics and echocardiographic and. factors associated with LVEF improvement were analyzed based on the rate of EF (>than 10% or 10% LVEF improvement) . This response trend (p<0.05) to be more related with female gender, hypertension history, absence of Diabetes, obesity, smaller baseline left ventricular end-diastolic dimension (LVEDD) and non-ischemic etiology. Conclusion Among Afro-Caribbean patients with HFrEF treated with conventional GDMT and ARNI therapy the rate of conversion from HFrEF to HFiEF was significant(p<0.01) suggesting improvement in cardiac remodeling.