Background: A significant, long-term side effect of breast cancer treatment is cardiovascular disease, which includes a variety of clinical manifestations including decline in left ventricular ejection fraction. Cardiac rehabilitation is a well-established multidisciplinary program targeting this risk profile and has been shown to reduce cardiac-specific mortality, and increase VO2 peak in patients with cardiovascular disease.

Aims: To determine whether cardiac rehabilitation is effective in preventing cancer therapy related cardiac dysfunction among breast cancer patients who underwent chemotherapy with anthracyclines and anti-HER2 antibodies.

Methods: PubMed, Cochrane and Embase databases were systematically searched from inception until 31 December 2024. The search key terms were ‘breast cancer,’ ‘cardiac rehabilitation,’ ‘anthracyclines/anti-HER2 antibodies,’ and ‘left ventricular ejection fraction.’ Two independent reviewers appraised the eligible studies using a well-defined criteria. The main outcomes of interest were improvement of LVEF with cardiac rehabilitation in breast cancer patients undergoing chemotherapy and its associated muscle strength.

Results: The search yielded 3 studies which were all randomized controlled trials. There were a total of 143 participants. Pooled estimates showed that there was no statistically significant difference between the intervention group vs the usual care group (effect size -0.134, p-value 0.256). The muscle strength however significantly improved in the intervention group vs the usual care group (effect size -0.024, p value 0.895).

Conclusions: The results of this meta-analysis did not find a substantial effect on the intervention group on LV ejection fraction vs. the usual care group. Further studies on this topic are needed as to enhance our aim of spreading cardiac rehabilitation awareness on these subset of patients.

Dr. Mary Martinae L. Miro is a 3rd year Adult Cardiology Fellow-in-training from Perpetual Succour Hospital – Cebu. She finished her Internal Medicine Residency training from the same institution. She has been a representative in the Debate team representing their institution for the Philippine Heart Association Annual Convention. She has also presented her research papers locally and internationally.