
Exercise intolerance is a primary symptom of heart failure in preserved ejection fraction (HFpEF) patients. A study with 246 HFpEF patients found 41% had chronotropic incompetence, linked to higher BMI, diabetes prevalence, β-blocker use, and worse NYHA class. Those with incompetence showed diminished cardiac output during exercise, higher metabolic work, and poorer exercise capacity, leading to a higher risk of mortality or worsening HF events (hazard ratio 2.66). The study highlights the prevalence and impact of chronotropic incompetence in HFpEF.
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