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Purpose <p>Usage of beta-blockers may influence heart rate response during exercise testing. The study aimed to investigate the impact of Propranolol, a non-selective beta-blocker, on the predictive validity of a commonly used submaximal cycle test, the Ekblom-Bak test (EB-test), for the estimation of maximal oxygen uptake (<i>V</i>O<sub>2</sub> max).</p> Methods <p>The study was a double-blinded crossover study including 28 participants (14 women), aged 21–59&#xa0;years. <i>V</i>O<sub>2</sub> max was estimated by the EB-test and measured during a maximal incremental exercise test during placebo and 10&#xa0;mg Propranolol beta-blockade condition. The EB-test estimates <i>V</i>O<sub>2</sub> max based on the difference in heart rate, ΔHR, between two work rates (4&#xa0;min cycling on each), a factor corresponding to the higher rate, heart rate at the lower rate, and age.</p> Results <p>Maximal heart rate (mean ± SD; 165.5 ± 16.5 vs. 181.4 ± 9.8&#xa0;bpm), ΔHR (36.4 ± 13.2 vs. 43.0 ± 11.4&#xa0;bpm), and measured <i>V</i>O<sub>2</sub> max (48.2 ± 6.2 vs. 50.4 ± 7.0&#xa0;ml/kg/min, 3.55 ± 0.74 vs. 3.67 ± 0.71 L/min) were significantly lower in the beta-blockade condition compared to placebo (<i>P</i> = &lt; .001). This led to an overestimation of <i>V</i>O<sub>2</sub> max by the EB-test during beta-blockade, + 0.377 L/min (95% CI 0.281–0.473 L/min, + 11.2%), with no overestimation seen in the placebo condition, + 0.030 L/min (95% CI (− 0.112)–0.172 L/min + 0.8%). The coefficient of variance, indicating variance of estimated <i>V</i>O<sub>2</sub> max on an individual level, was lower during beta-block condition, 6.6%, compared to placebo, 9.9%.</p> Conclusion <p>The EB-test systematically overestimated <i>V</i>O<sub>2</sub> max compared to measured <i>V</i>O<sub>2</sub> max during beta-blockade condition. Future research is needed to refine the test equation for usage in populations using beta-blockers.</p>

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The impact of propranolol on the predictive validity of estimated VO2 max by the Ekblom-Bak submaximal cycle test: a double-blind crossover study

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  • 发表日期：

    2025年4月15日

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  • Simon Östh,
  • Torbjörn Helge,
  • Elin Ekblom-Bak

摘要

Purpose

Usage of beta-blockers may influence heart rate response during exercise testing. The study aimed to investigate the impact of Propranolol, a non-selective beta-blocker, on the predictive validity of a commonly used submaximal cycle test, the Ekblom-Bak test (EB-test), for the estimation of maximal oxygen uptake (VO2 max).

Methods

The study was a double-blinded crossover study including 28 participants (14 women), aged 21–59 years. VO2 max was estimated by the EB-test and measured during a maximal incremental exercise test during placebo and 10 mg Propranolol beta-blockade condition. The EB-test estimates VO2 max based on the difference in heart rate, ΔHR, between two work rates (4 min cycling on each), a factor corresponding to the higher rate, heart rate at the lower rate, and age.

Results

Maximal heart rate (mean ± SD; 165.5 ± 16.5 vs. 181.4 ± 9.8 bpm), ΔHR (36.4 ± 13.2 vs. 43.0 ± 11.4 bpm), and measured VO2 max (48.2 ± 6.2 vs. 50.4 ± 7.0 ml/kg/min, 3.55 ± 0.74 vs. 3.67 ± 0.71 L/min) were significantly lower in the beta-blockade condition compared to placebo (P = < .001). This led to an overestimation of VO2 max by the EB-test during beta-blockade, + 0.377 L/min (95% CI 0.281–0.473 L/min, + 11.2%), with no overestimation seen in the placebo condition, + 0.030 L/min (95% CI (− 0.112)–0.172 L/min + 0.8%). The coefficient of variance, indicating variance of estimated VO2 max on an individual level, was lower during beta-block condition, 6.6%, compared to placebo, 9.9%.

Conclusion

The EB-test systematically overestimated VO2 max compared to measured VO2 max during beta-blockade condition. Future research is needed to refine the test equation for usage in populations using beta-blockers.