This study simultaneously addresses key questions about the role of exercise in heart failure among the elderly, both at the population and molecular levels. The incidence and prevalence of heart failure are growing dramatically in this age group, but current therapeutic agents have failed to yield substantial improvements in clinically relevant outcomes (4). Data from nonrandomized and 14 small phase II randomized, controlled trials, as well as the landmark HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training) study of >2,300 heart failure patients, have supported the conclusion that exercise training improves quality of life and exercise capacity, and reduces the risk of heart failure hospitalization ((5),(6),7). Professional societies advocate regular physical activity and exercise training in patients with heart failure, and recently published European guidelines have afforded these recommendations 1A status ((8),(9),10). Nonetheless, this treatment modality remains significantly underused in real-world settings, and its effectiveness in elderly patients with early stage heart failure has not been well studied (11). The current study adds credence to the notion that this population, too, may benefit from exercise.