As we age we are increasingly challenged by physical activities. Regular exercise is an essential medicine to maintain a level of function that encompasses simple activities as we age. On the flip side, a lack of exercise leads to a lack of heart conditioning that can contribute to a lack of heart capacity resulting in shortness of breath and heart failure with stressors such as illness or physical activity. Does the concept of exercise deficiency apply to all cases of HFPEF? In this interview, Professor Andre La Gerche MD, PhD and Christopher M. Kramer MD, FACC discuss a recent piece in JACC: HFpEF as an Exercise Deficiency Syndrome.