There are objective similarities between heart failure and muscular deconditioning. Deficiencies in peripheral blood flow and skeletal muscle function, morphology, metabolism and function are present. The protective effects of physical activity have been elucidated in many recent studies: training improves ventilatory control, metabolism and autonomic nervous system. Exercise training seems to induce its beneficial effects on the skeletal muscle both directly (on function, histological and biochemical characteristics) and indirectly by reducing the activation of the muscle neural afferents (ergoreceptors). On this basis a skeletal muscle origin of symptoms in heart failure has been proposed. The possible metabolic mediators of ergoreceptors are currently being under investigation and they could be a possible target of therapy in heart failure symptoms.