Cardiac dysfunction and skeletal muscle dysfunction are extrapulmonary consequences of lung hyperinflation in chronic obstructive pulmonary disease (COPD). Several studies demonstrated that lung hyperinflation is related to an underfilling of the heart, which in turn leads to a reduced cardiac output and is associated with a further worsening of exercise intolerance in COPD. Interventional studies showed that cardiac function can be improved by interventional measures for reduction of lung hyperinflation. Skeletal muscle deconditioning due to exercise intolerance is an indirect consequence of lung hyperinflation in COPD.