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Norepinephrine released from the synaptic terminal binds to the beta adrenergic receptor on cardiac myocytes, leading to the activation of Gs/adenylyl cyclase and thus production of cAMP.cAMP, a major second messenger, initiates cascades of phosphorylation reactions within the cell.The final outcome is the enhancement of cardiac inotropic and chronotropic effects.Overactivation of the sympathetic nervous system in chronic heart failure has been well known.