Exercise Intolerance in Patients With Heart Failure: JACC State-of-the-Art Review

Highlights •Exercise intolerance, a hallmark of patients with HF, is associated with poor function, QoL, and prognosis. •Although patients with HF typically have reduced cardiac reserve, other factors can variably and meaningfully contribute to the syndrome, and even represent the predominant mechanism of exercise intolerance. •Pharmacological and nonpharmacological treatments for HF with proven beneficial effects on clinical outcomes have variable effects on exercise and functional capacity. •Understanding the pathophysiology of exercise intolerance may allow for the development of targeted therapeutic strategies to improve exercise and functional capacity.