Excerpt

Diseases of the heart and lungs are both frequent, and their co-existence has a fundamental impact on patients’ morbidity and mortality. The proper interplay between cardiac and pulmonary function is of utmost importance for maintaining a normal hemodynamic state as well as for sufficient tissue oxygenation. Disturbed function of one of these organ systems may partly be compensated by the other, although cardiac disease mostly impairs pulmonary function, and vice versa [1, 2]. The co-existence of heart and lung disease is generally associated with exaggerated symptoms and diminished survival. For instance, extensive work has recently highlighted that chronic heart failure (HF) and chronic obstructive pulmonary disease (COPD) coincide in a significant number of patients, which carries a deleterious prognostic impact [3‐5]. In addition to shared risk factors and mechanisms (i.e., aging, unhealthy lifestyle), both conditions may result in a chronic inflammatory burden, which may worsen the disease course, weaken the patients’ functional status, and perturb the hemodynamics of the cardiopulmonary vascular system [1]. Further to diagnostic and therapeutic gaps in treating patients with both heart and lung disease, targeted therapies (e.g., HF and COPD medications) may either be underused and/or may have an impact on the other respective organ system [1, 2]. In this context, beta-blockers are frequently underused or underdosed in patients with HF and COPD [1, 2, 5]. Intriguingly, increasing evidence in the field of respiratory medicine indicates the potential beneficial effects of beta-blockers in COPD patients by preventing exacerbations, regardless of the presence of cardiovascular conditions for which they are indicated [6]. Furthermore, pulmonary hypertension (PH) may complicate left heart diseases including HF and left-sided valvular heart disease, representing an increased right ventricular (RV) afterload that may thus lead to RV dysfunction and diminished RV/PA(pulmonary artery) coupling [7‐9]. …