Heart failure (HF) and chronic obstructive pulmonary disease (COPD) coincide in a significant number of patients. Recent population-based registries suggest that spirometry is largely underused in patients with HF to diagnose comorbid COPD and that patients with COPD frequently do not receive the recommended beta-blocker (BB) treatment. This state-of-the-art review summarizes: 1) current challenges in the implementation of recommended spirometry for COPD diagnosis in patients with HF; and 2) current underuse and underdosing of BBs in patients with HF and COPD despite guideline recommendations. Open issues in the therapeutic management of patients with HF and COPD are discussed in the third section, including the use of the nonselective BB carvedilol, target BB doses in patients with HF and COPD, BB and bronchodilator management during HF hospitalization with and without COPD exacerbation, and the use of BBs in patients with COPD with right HF or free from cardiovascular disease. The whole scenario described herein advocates for a bipartisan initiative to drive immediate attention to the translation of guideline recommendations into clinical practice for patients with HF with co-occurring COPD.

许多患者同时患有心力衰竭（HF）和慢性阻塞性肺疾病（COPD）。最近的基于人口的注册管理机构表明，在HF患者中，肺活量测定法不足以诊断合并症COPD，而COPD患者经常不接受推荐的β受体阻滞剂（BB）治疗。这项最新的综述总结如下：1）在心力衰竭患者中实施推荐的肺活量检查以进行COPD诊断的当前挑战；2）尽管有指南建议，目前HF和COPD患者BB的使用不足和剂量不足。第三部分讨论了HF和COPD患者的治疗管理中的未解决问题，包括非选择性BB卡维地洛的使用，HF和COPD患者的目标BB剂量，在有或没有COPD急性加重的HF住院期间，BB和支气管扩张剂的管理，以及在患有右HF或无心血管疾病的COPD患者中使用BBs。本文所述的整个方案倡导两党倡议，以促使人们立即关注将指南建议转化为合并有COPD的HF患者的临床实践。