Clinical Research Directory

Inclusion Criteria: 1. A definite diagnosis of HFrEF (LVEF≤40%), NYHA II to IV , and the disease is due to ischemic heart disease or dilated cardiomyopathy; 2. A definite diagnosis of COPD with moderate or higher airflow limitation (FEV1/FVC \< 0.7 and FEV1 \< 80% of the expected value); 3. Age ≥18 years old; 4. Informed consent has been obtained and signed. 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.