Response to the Letter to the Editor We would like to thank the editor for the opportunity to respond to the letter from Drs. Ekrem S¸ahan, Suzan S¸ahan, and Murat Karamanlıo˘glu regarding our article (Gonzalez-Costello, J., et al., 2013. Chronotropic incompetence predicts mortality in severe obstructive pulmonary disease. Respir. Physiol. Neurobiol. 188 (2), 113–118). The letter questions whether heart rate variability is reliable in the assessment of chronotropic incompetence in the context of several potentially confounding factors such as coronary artery dysfunction, thyroid function and treatment with bronchodilators in our retrospective study of patients with advanced pulmonary disease. With regard to the first issue: we excluded patients with a left ventricular ejection fraction