Backgroud: The long term prognosis of preserved left ventricle systolic function (PLVSF) in patients with coexistent chronic heart failure (CHF) and chronic obstructive lung disease (COPD) have not been investigated. Medthods: We investigated a cohort 184 patients with coexistent CHF and COPD in retrospective study. Primary end point was cardiovascular event-free survival during 3 years (1095 days). LV systolic function was divided into PLVSF and LV systolic dysfunction (LVSD) defined as LV ejection fraction ���50% or <50% by echocardiogram. Results: Among 184 coexistent CHF and COPD patients, PLVSF was present in 98 cases (53.3%), and LVSD was present in the remaining 86 cases (46.7%). The mean (짹SD) of follow-up time was 731 짹 369 days. Patients with PLVSF compared to LVSD were more likely to be older and female, and have different GOLD stages, higher ejection fraction, higher FEV1, higher Hs-CRP, higher LV mass/body surface area, lower ischemic CHF origin, lower BNP, lower serum creatinine, lower regional wall motion abnormality, and lower beta-blocker use in baseline characteristics. Cardiovascular hospitalization or mortality occurred in 71 patients (38.6%) during maximum 3 years of follow-up: 38 (38.8%) in PLVSF group and 33 (38.4%) in LVSD group. There was no significant difference between PLVSF and LVSD in the cardiovascular event-free survival (Log Rank P=0.457). Cardiovascular event-free survival was independently associated with NYHA III class (P=0.018), GOLD III stage (P=0.037), and beta-blockers use (P=0.009) using a Cox proportional hazards model. Conclusions: In coexistent CHF and COPD patients, cardiovascular event-free survival of preserved LV systolic function compared to LV systolic dysfunction is similarly poor during 3 years follow-up. Severe NYHA class, severe GOLD stage, and beta-blockers use are independent predictors for cardiovascular event-free survival in patients with coexistent CHF and COPD patients.