We thank Dr. Aydogan for commenting on our article “Airway obstruction in systolic heart failure (SHF) — Chronic obstructive pulmonary disease (COPD) or congestion?” [1,2]. We agree that airway obstruction is a non-specific clinical sign [2,3]. We recently demonstrated that airway obstruction was often present during hospitalization for SHF (19%) but frequently resolved over time (48%) [2]. Furthermore, we revealed that a previously assigned diagnosis of COPD was often not confirmed if challenged by pulmonary function testing under stable conditions. Hence, COPD is indeed substantially over-diagnosed in patients with SHF (78%) [2]. In SHF, pulmonary congestion causes a transient airway obstruction with dyspnea, wheezing and cough mimicking the typical signs and symptoms of COPD. Even if chest X-ray then suggests pulmonary congestion, initial application of beta-agonists may be beneficial for fast symptom relief during an episode of acute cardiac failure. However, if the use of bronchodilators has been motivated by such circumstances, COPD may perpetuate in a patient's diagnosis and treatment plan. Permanent application of potentially harmful substances in SHF may then be the consequence [4]. As stated by Aydogan and colleagues, a similar scenario is possible in patients with heart failure and preserved ejection fraction (HFpEF). There, it might be sometimes difficult to differentiate pulmonary disease with fixed airway obstruction and secondary diastolic failure [5] from HFpEFtriggered congestion with secondary airway obstruction. We agree that further studies investigating diastolic function in patients with airway obstruction are needed. In our cohort of patients with stable SHF, we detected a fixed airway obstruction as the spirometric criterion of COPD diagnosis [3] in 9% [2]. Of those, 28%were never-smokers; this proportion is in accordance with the results of large population-based studies [6]. It has been shown that occupational risk factors, such as organic dust exposure, significantly contribute to the development of COPD in never-smokers [6,7]. Such detailed exposure capture, however, was outside the scope of our study. Finally, pulmonary function testing should be performed in any patient with dyspnea, wheezing and cough, but diagnosis and treatmentmust of course also rely on further integral findings such as patient history, symptoms, risk factors, chest X-ray and echocardiography [3].