. Dans-ce-contexte-clinique, le recours aux examens biologiques est fondamental et permet d'adapter la prise en charge thérapeutique. Pour la plupart des patients étudiés, la plainte principale exprimée était la dyspnée. Les bilans réalisés avaient pour but d'orienter sur la pathologie, d'éliminer une urgence et de chercher d'éventuels signes de gravité

P. La and . Était-de, mm Hg (± 18,4) -[38-61

L. Bnp and . Été, réalisés 183 fois (soit 43% des cas) Ils sont revenus inférieurs à 200 ng

W. A. Knaus, APACHE II, Critical Care Medicine, vol.13, issue.10, pp.818-847, 1985.
DOI : 10.1097/00003246-198510000-00009

C. and M. Cardiovasculaires, Société Française de Cardiologie, Editions Masson, pp.633-739, 2007.

K. R. , H. M. , and H. Hm, The cardiac mechanical stretch sensor machinery involves a Z disc complex that is defective in a subset of human dilated cardiomyopathy, Cell, vol.111, pp.943-55, 2002.

Z. R. , K. Ms, and Y. Wu, Calmodulin Kinase II inhibition protects against structural heart disease, Nat Med, vol.11, pp.409-426, 2005.

V. and G. A. Veksler-v, Energy metabolism in heart failure, J Physiol, vol.555, pp.1-13, 2003.

R. P. and K. Eg, Phospholamban: a Key determinant of cardiac function and dysfunction, Arch Mal Coeur, vol.98, pp.1239-1282, 2005.

C. Jn, L. Tb, and . Olivari, Plasma norepinephrine as a guide to prognosis to patients with chronic congestive heart failure, N Engl J Med, vol.311, pp.819-842, 1984.

B. Nadal-ginard, J. Kjstura, A. Leri, and P. Anversa, Myocyte Death, Growth, and Regeneration in Cardiac Hypertrophy and Failure, Circulation Research, vol.92, issue.2, pp.139-50, 2003.
DOI : 10.1161/01.RES.0000053618.86362.DF

URL : http://circres.ahajournals.org/content/circresaha/92/2/139.full.pdf

S. P. , U. Bf, and S. Er, Vasopressin antagonism: a future treatment option in heart failure, Eur Heart j, vol.26, pp.538-581, 2005.

P. V. Hein-s and K. S. , Matrix Metalloproteinases and their tissue inhibitors in pressure-overload human myocardium during heart failure progression, J Am Coll Cardiol, vol.44, pp.1609-1627, 2004.

D. Lj and S. K. , activation of the rennin-angiotensin-aldosterone system in hypertrophy and heart failure. Saunders, pp.129-173, 2004.

T. Jy, L. Me, and C. S. , Inflammation, cytokines and antiinflammatory therapies in heart failure, Arch Mal Coeur, vol.95, pp.204-216, 2002.

L. Guides and A. De-la-haute-autorité-de-santé, Insuffisance cardiaque à fonction systolique préservée systolique symptomatique chronique. Guide ALD n°5, 2007.

L. Ct, G. Nd, S. Ad, and M. Me, Heart failure in frail elderly patients: diagnostic difficulties, co-morbidities, polypharmacy and treatment dilemmas, Eur J Heart Fail, vol.4, pp.91-99, 2002.

H. Kk, P. Jl, K. Wb, and L. D. , The epidemiology of heart failure: the Framingham Study, J Am Coll Cardiol, vol.22, issue.4, pp.6-13, 1993.

D. , F. , A. Mercusot, and A. R. Sediq-sarwari, Épidémiologie de l'insuffisance cardiaque en Europe : épidémie du 21 e siècle, pp.62-72, 2006.

M. As, for the Breathing Not Properly multinational Study Investigators. Rapid measurement of B-Type Natriuretic Peptide in the emergency diagnosis of heart failure, N

R. Wj and S. K. , Task Force for the Diagnosis and Treatment of Chronic Heart Failure, European Society of Cardiology. Guidelines for the diagnosis and treatment of chronic heart failure, Eur. Heart J, issue.17, pp.221527-1560, 2001.

D. F. Serio, Analytical evaluation of the Dade Behring Dimension RxL automated N-Terminal proBNP (NT-proBNP) method and comparison with the Roche Elecsys, 2010.

J. Jl, The International Collaborative of NT-proBNP Study, Eur. Heart J, vol.27, pp.330-337, 2006.

. Hemodynamic, and neurohormonal effects of istaroxime, a novel intravenous inotropic and lusitropic agent : a randomized controlled trial in patients hospitalized with heart failure, JACC, vol.51, pp.2276-85, 2008.

M. Da, S. Bm, K. , M. Sa, B. A. et al., Effects of ranolazine on recurrent cardiovascular events in patients with non- ST-elevation acute coronary syndromes : the MERLIN-TIMI 36 randomized trial, JAMA, vol.297, pp.1775-83, 2007.

L. H. Cinaciguat, BAY 58-2667) improves cardiopulmonary hemodynamics in patient with acute decompensed heart failure, Circulation, vol.119, issue.21, pp.2752-2756, 2009.

T. Jr, A novel approach to improve cardiac performance : cardiac myosin activators, Heart Fail Rev, 2009.

T. Jr, Relaxin for the treatment of patients with acute heart failure

Z. , F. Mcmurray, and J. J. , Eplerenone in patients with systolic heart failure and mild symptoms, The New England Journal of Medicine, 2010.

M. A. Hoes, W Clinical epidemiology of heart failure, Heart, vol.93, issue.9, pp.1137-1183, 2007.

G. A. , G. S. Newby-d, S. F. Masson-m, and . Nicholl, Non- invasive Ventilation in Acute Cardiogenic Pulmonary Edema, New England Journal of Medecine, vol.359, pp.142-151, 2008.

M. C. , S. A. , and K. Lk, Use of B-Type Natriuretic peptide in the evaluation and management of acute dyspnea, N. Engl J Med, vol.350, pp.647-54, 2004.

M. Cullough, P. Nowak-rm, and . Mc-cord-j, B-Type Natriuretic Peptide and Clinical Judgment in Emergency Diagnosis of Heart Failure: Analysis From Breathing Not Properly (BNP) Multinational Study, Circulation, vol.106, issue.4, pp.416-438, 2002.
DOI : 10.1161/01.CIR.0000025242.79963.4C

C. A. and F. M. Conte-d, B-type natriuretic peptide in heart failure, N Engl J Med, vol.347, pp.1976-78, 2002.

C. Jg and C. Aguilar-jc, Management of heart failure in primary care (the improvement of heart failure program) : an international survey, Lancet, vol.360, pp.1631-1640, 2002.