Impact of beta‐blockers on cardiopulmonary exercise testing in patients with advanced liver disease

Summary Background Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta‐blockers reduce portal pressure and minimise haemorrhage risk. These medications may attenuate measures of cardiopulmonary performance, such as the ventilatory threshold and peak oxygen uptake measured via cardiopulmonary exercise testing. Aim To determine the effect of beta‐blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease. Methods This was a cross‐sectional analysis of 72 participants who completed a cardiopulmonary exercise test before liver transplantation. All participants remained on their usual beta‐blocker dose and timing prior to the test. Variables measured during cardiopulmonary exercise testing included the ventilatory threshold, peak oxygen uptake, heart rate, oxygen pulse, the oxygen uptake efficiency slope and the ventilatory equivalents for carbon dioxide slope. Results Participants taking beta‐blockers (n = 28) had a lower ventilatory threshold (P