@entity712 is associated with increased sympathetic nervous stimulation that results in down-regulation of myocardial @entity8652 receptors. The failing heart might depend more on @entity2263 receptors for positive inotropic support than the normal heart. Suppression of both @entity8652 and @entity2263 adrenoceptors by a non-selective beta-blocker, such as @entity1405 , is likely to eliminate the failing heart's much needed inotropic support, resulting in an exacerbation of symptoms. Use of a @entity8652 selective blocker, such as @entity1406 , on the other hand, is likely to be well tolerated. Unlike @entity1405 , the use of @entity1406 is associated with up-regulation of @entity8652 receptors. The clinical significance of the pharmacodynamic differences between these two beta-blockers in terms of their short-term hemodynamic and long-term beneficial effects is not clearly understood. However, in clinical trials, both @entity1405 and @entity1406 improved left ventricular function, @entity712 symptoms and survival. Both drugs are well tolerated as well. Aging itself is associated with elevated myocardial and serum @entity1063 levels, which is associated with down-regulation of @entity8652 receptors. In this article, we reviewed the literature to examine the clinical implications of this dual (age- and @entity712 -related) sympathetic stimulation and @entity8652 receptor down-regulation on selection of beta-blockers in older adults with @entity712 .

Myocardial beta-1 adrenoceptor down-regulation in aging and XXXX : implications for beta-blocker use in older adults with @entity712 .

@entity712 :: ('MESH:D006333', 'Disease') :: ['Heart failure', 'heart failure'] @entity8652 :: ('3779', 'Gene') :: ['beta-1'] @entity1405 :: ('MESH:C043211', 'Chemical') :: ['carvedilol'] @entity1406 :: ('MESH:D008790', 'Chemical') :: ['metoprolol'] @entity2263 :: ('10242', 'Gene') :: ['beta-2'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine']
@entity712 :: (MESH:D006333,Disease) :: ['heart failure']
