{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T18:32:09Z","timestamp":1794335529456,"version":"4.9.0"},"reference-count":51,"publisher":"American Medical Association (AMA)","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Cardiol"],"published-print":{"date-parts":[[2023,12,1]]},"abstract":"\n Importance<\/jats:title>\n Cardiovascular disease is a leading cause of morbidity in cancer survivors, which makes strategies aimed at mitigating cardiovascular risk a subject of major contemporary importance.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To assess whether a center-based cardiac rehabilitation (CBCR) framework compared with usual care encompassing community-based exercise training (CBET) is superior for cardiorespiratory fitness improvement and cardiovascular risk factor control among cancer survivors with high cardiovascular risk.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This prospective, single-center, randomized clinical trial (CORE trial) included adult cancer survivors who had exposure to cardiotoxic cancer treatment and\/or previous cardiovascular disease. Enrollment took place from March 1, 2021, to March 31, 2022. End points were assessed at baseline and after the 8-week intervention.<\/jats:p>\n <\/jats:sec>\n \n Interventions<\/jats:title>\n Participants were randomly assigned in a 1:1 ratio to 8 weeks of CBCR or CBET. The combined aerobic and resistance exercise sessions were performed twice a week.<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n \n The powered primary efficacy measure was change in peak oxygen consumption (V\u0307\n o<\/jats:sc>\n 2<\/jats:sub>\n ) at 2 months. Secondary outcomes included handgrip maximal strength, functional performance, blood pressure (BP), body composition, body mass index (BMI; calculated as weight in kilograms divided by height in meters squared), lipid profile, plasma biomarker levels, physical activity (PA) levels, psychological distress, quality of life (QOL), and health literacy.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 75 participants completed the study (mean [SD] age, 53.6 [12.3] years; 58 [77.3%] female), with 38 in the CBCR group and 37 in the CBET group. Participants in CBCR achieved a greater mean (SD) increase in peak V\u0307\n o<\/jats:sc>\n 2<\/jats:sub>\n than those in CBET (2.1 [2.8] mL\/kg\/min vs 0.8 [2.5] mL\/kg\/min), with a between-group mean difference of 1.3 mL\/kg\/min (95% CI, 0.1-2.6 mL\/kg\/min;\n P<\/jats:italic>\n \u2009=\u2009.03). Compared with the CBET group, the CBCR group also attained a greater mean (SD) reduction in systolic BP (\u221212.3 [11.8] mm Hg vs \u22121.9 [12.9] mm Hg;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), diastolic BP (\u22125.0 [5.7] mm Hg vs \u22120.5 [7.0] mm Hg;\n P<\/jats:italic>\n \u2009=\u2009.003), and BMI (\u22121.2 [0.9] vs 0.2 [0.7];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001) and greater mean (SD) improvements in PA levels (1035.2 [735.7] metabolic equivalents [METs]\/min\/wk vs 34.1 [424.4] METs\/min\/wk;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), QOL (14.0 [10.0] points vs 0.4 [12.9] points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001), and health literacy scores (2.7 [1.6] points vs 0.1 [1.4] points;\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Exercise adherence was significantly higher in the CBCR group than in the CBET group (mean [SD] sessions completed, 90.3% [11.8%] vs 68.4% [22.1%];\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion and Relevance<\/jats:title>\n \n The CORE trial showed that a cardio-oncology rehabilitation model among cancer survivors with high cardiovascular risk was associated with greater improvements in peak V\u0307\n o<\/jats:sc>\n 2<\/jats:sub>\n compared with usual care encompassing an exercise intervention in a community setting. The CBCR also showed superior results in exercise adherence, cardiovascular risk factor control, QOL, and health literacy.\n <\/jats:p>\n <\/jats:sec>\n \n Trial Registration<\/jats:title>\n \n ClinicalTrials.gov Identifier:\n NCT05132998<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamacardio.2023.3558","type":"journal-article","created":{"date-parts":[[2023,10,11]],"date-time":"2023-10-11T11:09:37Z","timestamp":1697022577000},"page":"1119","source":"Crossref","is-referenced-by-count":57,"title":["Cardio-Oncology Rehabilitation for Cancer Survivors With High Cardiovascular Risk"],"prefix":"10.1001","volume":"8","author":[{"given":"Sofia Gon\u00e7alves","family":"Viamonte","sequence":"first","affiliation":[{"name":"North Rehabilitation Center, Centro Hospitalar Vila Nova de Gaia\/Espinho, Vila Nova de Gaia, Portugal"},{"name":"ONCOMOVE\u2013Associa\u00e7\u00e3o de Investiga\u00e7\u00e3o de Cuidados de Suporte em Oncologia, Vila Nova de Gaia, 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