الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
B
reast cancer is the most common type of cancer in women and the first cause of cancer death among them 10. In Egypt, it is the most common cancer among females and constitutes 32.4% of cases1.
Anthracyclines are potent antineoplastic drugs that constitute a cornerstone in the treatment of sarcomas, breast cancer and hematological malignancies. Shortly after the introduction of these agents in the 1960’s, cardiac dysfunction was discovered to be an important dose-limiting side effect12. And the specific mechanisms of anthracycline cardiotoxicity still remain unclear.
A new field has emerged called Cardio-oncology (onco-cardiology) with a common aim of improving the morbidity among cancer patients at the same time of completing the cancer treatment 57-60.
A new multidisciplinary concept is introduced called Cardio-oncology rehabilitation (CORE) which aims to simultaneously decrease the risk of CVD and improve cardiopulmonary fitness among cancer patients during and after treatment 64.
Recently multiple studies were done to study the effect of cardiac rehabilitation programs on the improvement of LV functions in patients with acute myocardial infarction (AMI) who had been revascularized. And it was found that CR has beneficial effects on left ventricular global longitudinal and global circumferential strains, as well as EF, after AMI8,9.
However no studies were done to determine the Effect of cardiac rehabilitation on the LV functions in patients receiving chemotherapy induced-cardiotoxic drugs.
Objective was to determine the Effect of cardiac rehabilitation program on Left Ventricular systolic function in patients with breast cancer receiving Anthracycline based chemotherapy using two-dimensional speckle tracking echocardiography
from July 2021 to April 2023; 100 breast cancer patients were enrolled and was be divided on two groups; group one received Cardiac rehabilitation program as an addition to the traditional line of management. A follow up period of 3 and 6 months post chemotherapy using echocardiography with 2D speckle tracking was done and compared to that performed at baseline
In group 1, EF showed no significant changes through out the follow up period of 3 and 6 months Post chemotherapy (64.10 ± 3.52 at baseline, 62.86 ± 3.54 at 3 m., 64.10 ± 3.52 at 6 m, P= 0.083). Also average GLS didn’t show a significant change and remained constant through out the follow up period (from 18.86 ± 1.49 at baseline to -18.81 ± 1.39 at 3 m and-18.91 ± 1.39 at 6m., P= 0.081). In group 2, a significant change was detected as regarding the EF (from 62.8 ± 5.32 at baseline to 61.4 ± 4.76 at 3 months and 59.4 ± 5.57 at 6 months, P <0.001); however EF levels were still within the reference values (2D LVEF ≥ 53%). A significant reduction in Average GLS was observed (from -18.8 ± 1.42 at baseline to 18.2 ± 1.43 at 3 months and -17.9 ± 1.48 at 6 months, P <0.001).
In conclusion, cardiac rehabilitation program has a protective role against chemotherapy-induced cardiotoxicity in patients with breast cancer.
CONCLUSION
C
ardiac rehabilitation program has a protective role against chemotherapy-induced cardiotoxicity in patients with breast cancer.
RECOMMENDATIONS
C
ardiac rehabilitation program should be implemented as a part of management plan in cancer patients receiving cardiotoxic drugs such as anthracyclines.