关键词: 心力衰竭；肺疾病, 慢性阻塞性；射血分数；药物疗法；β受体阻滞剂；静息心率

Abstract: Background　Heart failure with reduced ejection fraction（HFrEF） often coexists with chronic obstructive pulmonary disease（COPD），which leads to a series of problems such as increased hospitalization rate，higher financial burden，worsening conditions and raised mortality.Objective　To examine the incidence of COPD in HFrEF，and to investigate the drug treatment for HFrEF with COPD.Methods　We recruited 238 hospitalized patients with HFrEF and NYHA class Ⅱ-Ⅳ from Cardiovascular Department，First Affiliated Hospital of Kunming Medical University，including 26 with COPD（HFrEF+COPD group） and 212 without（HFrEF group） in 2017．We comparatively analyzed both groups' general personal data，drug treatment including the use of β-blockers（BBs） and resting heart rate management.Results　The prevalence of COPD in the patients was 10.9%（26/238）．HFrEF+COPD group had lower rates of using BBs，and mineralocorticoid receptor antagonists（MRAs），but higher rate of using antiplatelet drugs compared with HFrEF group（P<0.05）．Both groups had no significant differences in the rates of using angiotensin-converting enzyme inhibitors（ACEI）/ angiotensin-receptor blockers（ARB），diuretics，digoxin and statins（P>0.05）．The rates of using metoprolol succinate，bisoprolol，metoprolol tartrate and carvedilol and the average total cumulative dose of each of these drugs showed no significant differences between the groups（P>0.05）．In the HFrEF group，the rates of using over 50% of the target dose but less than the target dose of metoprolol succinate，bisoprolol，metoprolol tartrate，and carvediloda were 2.4%（5/212），9.4%（20/212），4.7%（10/212），0.5%（1/212），respectively.And only 0.9%（2/212） used the target dose of bisoprolol.In the HFrEF +COPD group，the rates of using over 50% of the target dose but less than the target dose of metoprolol succinate，bisoprolol，metoprolol tartrate，and carvediloda were 0，7.7%（2/26），0，and 3.8%（1/26），respectively.No one used the targer dose of each of these drugs during treatment.The rates of having a resting heart rate of 55-60，61-70，and over 70 beats per minute were 3.3%（7 cases），35.4%（75 cases） and 60.8%（129 cases），respectively，in the HFrEF group，and 7.7%（2 cases），38.5%（10 cases） and 53.8%（14 cases） in HFrEF+COPD group，indicating no obvious differences between the groups（P>0.05）．Conclusion　The prevalence of COPD was high in HFrEF patients.BBs were used in HFrEF patients with or without COPD，but the use rate and dose are to be improved.Moreover，the rates of meeting the target resting heart rate were low in both groups.Therefore，more attention should be paid to the diagnosis and treatment of HFrEF with COPD.

Key words: Heart failure；Pulmonary disease, chronic obstructive；Ejection fraction；Drug therapy；Beta blocker；Resting heart rate