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With improved survival, the off\u2010target effects of chemotherapy, such as a decline in cardiorespiratory fitness and worse cardiovascular outcomes, have been recognized. Exercise training may help mitigate these effects. In this study, patients with breast cancer (\n                    <jats:italic>N<\/jats:italic>\n                    \u2009=\u200924) scheduled to undergo chemotherapy were randomized to either remotely administered high\u2010intensity interval training (HIIT) or moderate\u2010intensity exercise (MOD) based on ACSM guidelines for cancer survivors. HIIT involved three weekly sessions using the 4\u2009\u00d7\u20094 protocol at 85%\u201390% peak heart rate (PHR), while MOD consisted of 150\u2009min per week at 70%\u201375% PHR. Exercise training began 1\u20132\u2009weeks before chemotherapy and continued throughout treatment. Baseline testing was conducted prior to chemotherapy and follow\u2010up testing 7\u201310\u2009days after completion. Assessments included VO\n                    <jats:sub>2peak<\/jats:sub>\n                    , echocardiography, vascular function, and blood biomarkers. VO\n                    <jats:sub>2peak<\/jats:sub>\n                    significantly declined in MOD (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20098; 1.50\u2009\u00b1\u20090.23 to 1.27\u2009\u00b1\u20090.28\u2009L\/min;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.013,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20091.2), while remaining stable in HIIT (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20097; 1.58\u2009\u00b1\u20090.24 to 1.52\u2009\u00b1\u20090.28\u2009L\/min;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.445,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.3), with a large between\u2010group effect size (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.109,\n                    <jats:italic>d<\/jats:italic>\n                    \u2009=\u20090.9). NTproBNP levels significantly increased in MOD (104.3\u2009\u00b1\u200935.1 to 158.1\u2009\u00b1\u200956.0;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.018), but not in HIIT. The study was underpowered due to greater than anticipated dropout to detect significant between\u2010group differences in VO\n                    <jats:sub>2peak<\/jats:sub>\n                    . These data have implications for the design of scalable exercise interventions in patients undergoing chemotherapy for breast cancer.\n                  <\/jats:p>","DOI":"10.14814\/phy2.70787","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T06:57:12Z","timestamp":1771397832000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The effect of two remote exercise programs on cardiorespiratory fitness, cardiac function, and vascular health in patients with breast cancer"],"prefix":"10.14814","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0314-7679","authenticated-orcid":false,"given":"Nathan R.","family":"Weeldreyer","sequence":"first","affiliation":[{"name":"Integrated Cardiovascular Exercise Physiology (iCARE) Laboratory, College of health Sciences University of Alberta  Edmonton Alberta Canada"},{"name":"Department of Kinesiology University of Virginia  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