{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T14:06:23Z","timestamp":1773237983499,"version":"3.50.1"},"reference-count":28,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T00:00:00Z","timestamp":1502668800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with advanced liver disease may develop portal hypertension that can result in variceal haemorrhage. Beta\u2010blockers 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aim<\/jats:title><jats:p>To determine the effect of beta\u2010blockers on cardiopulmonary exercise testing variables in patients with advanced liver disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a cross\u2010sectional analysis of 72 participants who completed a cardiopulmonary exercise test before liver transplantation. All participants remained on their usual beta\u2010blocker 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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Participants taking beta\u2010blockers (n\u00a0=\u00a028) had a lower ventilatory threshold (<jats:italic>P<\/jats:italic>\u00a0&lt;.01) and peak oxygen uptake (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.02), compared to participants not taking beta\u2010blockers. After adjusting for age, the model of end\u2010stage liver\u2010disease score, liver\u2010disease aetiology, presence of refractory ascites and ventilatory threshold remained significantly lower in the beta\u2010blocker group (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.04). The oxygen uptake efficiency slope was not impacted by beta\u2010blocker use.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Ventilatory threshold is reduced in patients with advanced liver disease taking beta\u2010blockers compared to those not taking the medication. This may incorrectly risk stratify patients on beta\u2010blockers and has implications for patient management before and after liver transplantation. The oxygen uptake efficiency slope was not influenced by beta\u2010blockers and may therefore be a better measure of cardiopulmonary performance in this patient population.<\/jats:p><\/jats:sec>","DOI":"10.1111\/apt.14265","type":"journal-article","created":{"date-parts":[[2017,8,14]],"date-time":"2017-08-14T10:42:38Z","timestamp":1502707358000},"page":"741-747","source":"Crossref","is-referenced-by-count":9,"title":["Impact of beta\u2010blockers on cardiopulmonary exercise testing in patients with advanced liver disease"],"prefix":"10.1111","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2201-7933","authenticated-orcid":false,"given":"M. P.","family":"Wallen","sequence":"first","affiliation":[{"name":"School of Human Movement and Nutrition Sciences Centre for Research on Exercise, Physical Activity and Health(CRExPAH) The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia Princess Alexandra Hospital Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"K. A.","family":"Dias","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences Centre for Research on Exercise, Physical Activity and Health(CRExPAH) The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. S.","family":"Ramos","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences Centre for Research on Exercise, Physical Activity and Health(CRExPAH) The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S. E.","family":"Keating","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences Centre for Research on Exercise, Physical Activity and Health(CRExPAH) The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. J.","family":"Woodward","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"School of Medicine The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5704-2741","authenticated-orcid":false,"given":"T. L.","family":"Skinner","sequence":"additional","affiliation":[{"name":"School of Human Movement and Nutrition Sciences Centre for Research on Exercise, Physical Activity and Health(CRExPAH) The University of Queensland Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"G. A.","family":"Macdonald","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Princess Alexandra Hospital Brisbane Qld Australia"},{"name":"School of Medicine The University of Queensland Brisbane Qld Australia"},{"name":"Department of Physical Therapy College of Applied Health Sciences University of Illinois at Chicago Chicago IL USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"Arena","sequence":"additional","affiliation":[{"name":"Translational Research Institute Brisbane Qld Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. 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