Selective cardiac adrenergic activation occurs early in mild-to-moderate heart failure, preceding the generalized sympathetic activation characteristic of advanced disease.
These results indicate a selective increase in cardiac adrenergic drive (increased amounts of transmitter available at neuroeffector junctions) in patients with mild-to-moderate CHF. This increase appears to precede the augmented sympathetic outflow to the kidneys and skeletal muscle found in advanced CHF.
Rundqvist et al. (Tue,) studied this question.