Sympathetic activation in congestive heart failure: Reproducibility of neuroadrenergic markers

Guido Grassi, Gianbattista Bolla, Fosca Quarti-Trevano, Francesca Arenare, Gianmaria Brambilla, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review


Objective: To assess the reproducibility of the two markers of adrenergic drive, venous plasma norepinephrine (NE) and efferent postganglionic muscle sympathetic nerve activity (MSNA), in reflecting the sympathetic activation characterizing congestive heart failure (CHF). Methods and measurements: In 19 CHF male normotensive patients (mean age: 53.0 ± 2.1 years, NYHA classes II and III, left ventricular ejection fraction 35.9 ± 2.9%), blood pressure (BP, Finapres), heart rate (EKG), plasma NE (HPLC assay) and MSNA (microneurography, peroneal nerve) were measured in two experimental sessions separated by a week interval. At each session, three NE samples were obtained and NE reproducibility between sessions was assessed by considering single NE samples or averaging 2-3 samples. Results: While MSNA values showed a highly significant correlation between sessions (r = 0.85, P <0.001), NE values based on a single blood sample evaluation did not correlate with each other (r = 0.41, P = NS). NE correlation coefficients improved and achieved statistical significance when average data from 2 and 3 blood samples were examined (r = 0.54 and r = 0.57, P <0.02 for both). Conclusions: In CHF, MSNA displays a better reproducibility pattern than plasma NE. The reproducibility of the NE approach, however, can be improved by performing the assay on multiple blood samples.

Original languageEnglish
Pages (from-to)1186-1191
Number of pages6
JournalEuropean Journal of Heart Failure
Issue number12
Publication statusPublished - Dec 2008


  • Heart failure
  • Muscle sympathetic nerve activity
  • Muscle sympathetic nerve traffic
  • Plasma norepinephrine
  • Sympathetic activity

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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