This work was interested in 72 patients (81% males) with chronic heart insufficiency. Ail these patients had a sinusal rythme. The etiology was mainly idiopathic (36%) but also ischemic (64%). 15% of patients were at stage I of NYHA, 37.5% at NYHA II, 40.5% at NYHA III and 7% at NYHA IV. All patients had taken a medical treatment (in 85% of cases, this treatment was based on diuretics and IEC). Transthoracic echocardiography was performed in these patients to determine the telediastolic diameter (TDD = 69 mm), the telesystolic diameter (TSD = 57), the velocity of E wave (0.66 mis) and A wave (0.55 mis) and the E wave deceleration time (DT = 0.196 s), 11 from ali patients were dead after a period of observation 21 months. The factors of pejorative prognostic were: the stages III and IV of NYHA, the cardiothoracic ratio > 0.60 and the echocardiographic parameters: TDD, TSD and DT (p = 0.03, p = 0.02 and p = 0.0001 respectively). But the E and A velocity seems don't influence the prognostic.