Cultural Background The major earthquake which struck L’Aquila on 6 April 2009 was a real tragedy that caused more than three hundred victims, including several students of our University and twenty children. Thousands of buildings were damaged or destroyed in the very heart of the city, including magnificent monuments and churches. More than 60.000 people have been left homeless in 32 seconds. Six years have now passed and nothing has changed: the center is almost the same that the quake left on that morning of 6 April 2009. However, the University and the Hospital have never lost their core role in the culture of the city. A new Auditorium by the Architect Renzo Piano has been opened in the center, close to the Spanish fortress. The proud population of L’Aquila has reacted with strength and courage against the tragedy and has been working hard to start a new life and to foster previous cultural activities. With the support of Fondazione Menarini, our contribute to the cultural renaissance of this wonderful city will be this International Meeting. We are confident that the participation of skilled experts and delegates coming from abroad will give L’Aquila a small but valuable contribution to its cultural renaissance. Non omnis moriar (Not all of me will die) - Quintus Horatius Flaccus Scientific Background Previous definition of COPD focused on either clinical characteristics (i.e. cough and/or dyspnea) or anatomic features (i.e. enlargement of alveolar spaces). Thus, this definition contributed to underestimation of COPD relevance and understanding the complexity of the disease. Currently, COPD might be defined as “a common preventable and treatable disease, characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases.” This definition remains broad, describing an “airflow limitation” that, in turn, is due to various features of small-airway disease, chronic bronchitis, and emphysema that may be highly variable with time and/or within patients despite identical measures of airflow limitation measured by the forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio. In this regard, various studies have begun to reveal a new understanding of the physiopathology, public health impact, and overall complexity of COPD. In particular, COPD is currently seen as a multifaceted disease with a markedly increased cardiovascular risk that is deeply modified by its own therapy and multiple factors, mainly represented by multimorbidities. Arterial hypertension, type 2 diabetes, heart failure, CHD and ventricular or supraventricular arrhythmias are the most commonly observed comorbidities in COPD patients. The therapy of COPD can deeply influence the cardiovascular risk profile, while “cardiovascular drugs” can, in turn, exert either no or detrimental effects on respiratory function. It is now the time to unmask these forgotten interactions and generate an operative collaboration between COPD and cardiovascular treatments in order to reduce global cardiovascular risk and overall mortality. We must understand that patients affected by cardiovascular disease often manifest with COPD and vice versa. The therapy of one of the two comorbidities must have at least no negative effects on the second one and contribute to improve life quality and expectancy.
Claudio Ferri Chairman of the Meeting