Update in diagnosis and therapy of coexistent chronic obstructive pulmonary disease and chronic heart failure
Chronic obstructive pulmonary disease (COPD) and chronic heart failure (CHF) frequently coexist in clinical practice as they share the same risk factors. The manifestations of COPD and CHF are similar. Exertional dyspnoea, easy fatigability and reduced exercise tolerance are common to COPD and CHF and required careful interpretation. Pulmonary function tests, plasma natriuretic peptides, echocardiography and cardiovascular magnetic resonance imaging should be carried out to acquire the objective evidence of pulmonary and cardiac function when necessary. Robust studies indicate that patients with COPD tolerate the cardioselective β-blockers well, so it should not be denied to CHF patients with concomitant COPD. Low-dose initiation and gradual uptitration of cardioselective β-blockers is currently recommended. However, β2-agonists should be used with cautions in COPD patients with CHF, especially in acute exacerbations. Statins, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers may reduce the morbidity and mortality of the patients with COPD.