Metoprolol in Patients With HFrEF and COPD

Exclusion Criteria

• •1. the dose of Metoprolol before enrollment was more than 23.75mg/d;
• •2. Resting heart rate \< 50 beats/min;
• •3. Second or third degree atrioventricular block;
• •4. Atrial fibrillation;
• •5. Sick sinus syndrome;
• •6. Systolic blood pressure \< 90mmHg;
• •7. Acute attack of bronchial asthma;
• •8. Liver insufficiency (serum transaminase \> 3 times the normal value);
• •9. Renal insufficiency (eGFR \< 30ml/min/1.73m2, or serum creatinine \> 2.5mg/dL\[\> 221μmol/L\]);
• •10. Patients with serious physical diseases, such as cancer;
• •11. Patients who have a history of allergy to the investigational drug or its ingredients;
• •12. Participating in other clinical investigators;
• •13. During the study period, Patients cannot live in the selected center for a long time, which is not conducive to the follow-up;
• •14. Patients with disability, mobility disability, intellectual disability and other factors that may prevent normal participation in the study and follow-up, and their frailty was assessed by the FRAIL frailty screening scale; Intellectual mental status was assessed by the Mini-Mental State Examination (MMSE).
• •15. Poor adherence or other reasons considered by the researchers to be unsuitable for the clinical trial.