Deactivation of pulmonary stretch receptors is a cause of sympathetic overactivation in patients with heart failure, but it remains unknown whether impaired lung function is independently associated with sympathetic overactivation. Decreased functional vital capacity was an independent predictor of increased level of direct measures of sympathetic nerve outflow. Changes in percentage of vital capacity negatively correlated with those in sympathetic nerve activity during follow-up. Restrictive lung function is associated with increased sympathetic nerve activity independently from heart failure severity.