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Table 1 Characteristics of included trails

From: Effectiveness of aerobic exercise intervention on cardiovascular disease risk in female breast cancer: a systematic review with meta-analyses

Study

Study design

Stage

Sample size

Age (years)

Cancer Treatment

Aerobic exercise protocol in Intervention Group

Principles of exercise

Outcomes

T

C

Chung et al. [29] (2021)

RCT. Single-center

±õ—I±õ±õ

16

13

T 52.4 ± 8.9

C: 50.3 ± 7.7

AC

Aerobic exercise modality: Continuous. Time: 40 min/ sessions. Frequency: 2–3 sessions /w. Duration: 3m. Intensity:70%-75% VO2max

Linear

(5)(22)

De Luca et al. [30] (2016)

RCT. Single-center

±õ—I±õ±õ

10

10

T: 50.2 ± 9.7

°ä:46.0 ±â¶Ä‰2.8

Chemotherapy, radiation, hormonal therapy

Aerobic exercise modality: Continuous. Time: 30 min/ sessions. Frequency: 2 sessions /w. Duration: 24w. Intensity:70%-75% HR max

Linear

(5)(12)

Lee et al. [31] (2020)

RCT. Single-center

0 to 3

48

45

T: 52.8 ± 10.6

C: 53.6 ± 10.1

Chemotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min per session by week 16. Frequency: 3 sessions /w. Duration: 16w. Intensity:65%-80% HR max

Nonlinear

(7)(18)(20)(21)

Hornsby et al. [32] (2013)

RCT. Single-center

±õ±õµþ—I±õ±õ

10

10

T: 51 ± 6

C: 46 ± 11

AC, neoadjuvant chemotherapy

Aerobic exercise modality: Continuous & Interval. Time:1st w: 15–20 min/ sessions. 2nd -4th w: 30min/ sessions.5th -6th w: 30—45min/sessions. 7th -9th w: 20min/ sessions. 10th -12th w: 20min / sessions. Frequency: 3 sessions /w. Duration: 12w. Intensity: 1st – 4th w: 60% VO2max. 5th-6th w: 60%-65% VO2max; 7th -9th w: 60%-70% VO2max; 10th -12th w: 60%-70%VO2max & 100%VO2max

Nonlinear

(5)(22)

Dieli-Conwright et al. [33] (2018)

RCT. Single-center

±õ—I±õ±õ

48

45

T: 52.8 ± 10.6

C: 53.6 ± 10.1

Chemotherapy, radiotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min per session by week 16. Frequency: 3 sessions /w. Duration: 16w. Intensity: 65%-80% HR max

Nonlinear

(6)(8)(10)(11)(12)(13)(14)

Dieli-Conwright et al. [34] (2018)

RCT. Single-center

±õ—I±õ±õ

48

45

T: 52.8 ± 10.6

C: 53.6 ± 10.1

Chemotherapy, radiotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min per session by week 16. Frequency: 3 sessions /w. Duration: 16w. Intensity: 65%-80% HR max

Nonlinear

(5)

Lee et al. [35] (2019)

RCT. Single-center

±õ—I±õ±õ

48

45

T: 52.8 ± 10.6

C: 53.6 ± 10.1

Chemotherapy, radiotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min per session by week 16. Frequency: 3 sessions /w. Duration: 16w. Intensity: 65%-80% HR max

Nonlinear

(9)(19)

Cornette et al. [36] (2016)

RCT. Single-center

±õ—I±õ±õB

20

22

T: 49

C: 52

3 FEC100, 3

Aerobic exercise modality: Continuous. Time: Start with 20 min, increase by 5 min per 6 weeks. Frequency: 3 sessions /w. Duration: 27w. Intensity: 18 ± 2 maximum rated perceived exertion

Nonlinear

(5)

Ochi et al. [37] (2022)

RCT. Single-center

early-stage

21

23

Ìý

Hormone therapy

Aerobic exercise modality: High Intensity Aerobic Interval. Time: NA. Frequency: 3 sessions /w. Duration: 12w. Intensity: Maximum rated perceived exertion 18 ± 2

Linear

(5)

Courneya et al. [38] (2003)

RCT. Single-center

±õ—I±õ±õA

24

28

T: 59 ± 5

C: 58 ± 6

_

Aerobic exercise modality: Continuous. Time: Start with 15 min and increase by 5 min every 3 weeks. Frequency: 3 sessions /w. Duration: 15w. Intensity: 70%—75% VO2max

Nonlinear

(5)(6) (10)

Scott et al. [39] (a) (2020)

RCT. Single-center

±õ—I±õ±õ

58

57

T: 59 ± 9

C: 58 ± 9

Surgery, chemotherapy, radiotherapy, endocrine therapy

Aerobic exercise modality: Continuous. Time:1st-4th w:30–40 min; 5th -16th w: 40. Frequency: 1st – 3rd w: 3 sessions /w; 4th -16th w: 4 sessions /w. Duration: 16w. Intensity: 1st – 3rd w: 55%-60% VO2max, 4th -16th w: 60%—70% VO2max

Linear

(5)

Scott et al. [39] (b) (2020)

RCT. Single-center

±õ—I±õ±õ

59

57

T: 58 ± 9

C: 58 ± 9

Surgery, chemotherapy, radiotherapy, endocrine therapy

Aerobic exercise modality: Interval. Time: 120 min/week. Duration: 16w. Intensity: alternated between five different dose intensities (55%, 65%, 75%, 80%, and > 95%) of VO2max

Nonlinear

(5)

Vincent et al. [40] (2020)

RCT. Single-center

±õ—I±õ±õ

55

26

-

FEC & TZB & TAX

Aerobic exercise modality: Continuous. Time: 30 min/week. Frequency: 2 sessions /w. Duration: 6m. Intensity: 60%—70% VO2peak

Linear

(5)(6)(11)

Hojan et al. [41] (2020)

RCT. Single-center

±õµþ—I±õ±õ´¡

26

21

T: 54.44 ± 6.29

C: 54.64 ± 5.26

TZB

Aerobic exercise modality: Continuous. Time: 45–50 min/week. Frequency: 5 sessions /w. Duration: 9w. Intensity: 80% HR max

Linear

(21)(22)

Murtezani et al. [42] (2014)

RCT. Single-center

±õ—I±õ±õA

30

32

T: 53 ± 11

C: 51 ± 11

Surgery

Aerobic exercise modality: Continuous. Time: Start with 15 min, increase by 2 min per week. Frequency: 3 sessions /w. Duration: 10 w. Intensity: 50% -75%HRR

Nonlinear

(6)(10)

Lee et al. [35] (2019)

RCT. Single-center

±õ—I±õ±õ

15

15

T: 47.1 ± 7.9

C: 44.7 ± 11.2

AC

Aerobic exercise modality: High Intensity Aerobic Interval. Time: 20 min. Frequency: 3 sessions /w. Duration: 8 w. Intensity: 7 times of a 1- min interval performed at 90% PPO; followed by a 2 – min interval performed at 10% PPO

Linear

(5)

Courneya et al. [43] (2007)

RCT. Single-center

±õ—I±õ±õA

71

73

T: 49

C: 49

AC & TAX & FEC100C, CE120F

Aerobic exercise modality: Continuous. Time: Start with 15 min and increase by 5 min every 3 weeks. Frequency: 3 sessions /w. Duration: 8 w. Intensity: 60% -80% VO2max

Nonlinear

(5)(10)(11) (12)(13)

Jones et al. [44] (2013)

RCT. Single-center

±õ±õµþ—I±õ±õC

10

10

T: 51 ± 6

C: 46 ± 11

AC

Aerobic exercise modality: Continuous & Interva. Time: 1st w: 15–20 min/ sessions. 2nd -4th w: 30min/ sessions. 5th -6th w: 30-45min/ sessions. 7th -9th w: 20min/ sessions. 10th -12th w: 20min / sessions. Frequency: 3 sessions /w. Duration: 12 w. Intensity: 1st – 4th w: 60% VO2max. 5th-6th w: 60%-65%VO2max. 7th -9th w: 60%-70%VO2amx. 10th -12th w: 60%-70%VO2max & 100%VO2max

Nonlinear

(5)

Irwin et al. [45] (2009)

RCT. Single-center

±õ—I±õ±õA

37

38

T: 56.5 ± 9.5

C: 55.1 ± 7.7

Radiation and chemotherapy

Aerobic exercise modality: Continuous. Time: 15–30 min/ sessions. Frequency: 3 sessions /w. Duration: 6m. Intensity: 50% increased to 60%-80% HRmax

Nonlinear

(6)(10)(12)(13)(14)(15)

Northey et al. [46] (a) (2019)

RCT. Single-center

±õ—I±õ±õ

5

6

T: 67.8 ± 7.0

C: 61.5 ± 7.8

Surgery, chemotherapy, radiation. Aromatase inhibitor

Aerobic exercise modality: Continuous. Time: 20 min/ sessions. Frequency: 3 sessions /w. Duration: 12w. Intensity: 55—65%³Õ°¿2max

Linear

(5)

Northey et al. [46] (b) (2019)

RCT. Single-center

±õ—I±õ±õ

6

6

T: 60.3 ± 8.1

C: 61.5 ± 7.8

Surgery. Radiation. Aromatase inhibitor

Aerobic exercise modality: High Intensity Aerobic Interval. Time: 20 min/ sessions. Frequency: 3 sessions /w. Duration: 12w. Intensity: 4 intervals in 1st w, increased by one each week until the target of 7 intervals was achieved in 4th w 50—90% VO2max

Nonlinear

(5)

Fairey et al. [47] (2005)

RCT. Single-center

±õ—I±õ±õA

24

28

T: 59 ± 5

C: 58 ± 6

Surgery, radiation, chemotherapy

Aerobic exercise modality: Continuous. Time: 15min for weeks 1 through 3, and then systematically increased by 5min every three weeks thereafter to 35 min for weeks 13 through 15. Frequency: 3 sessions /w. Duration: 15w. Intensity: 70—75% VO2max

Nonlinear

(17)(18)(19)(20)(21)

Irwin et al. [48] (2015)

RCT. Single-center

0—I±õ±õ

45

38

T: 62 ± 7.0

C: 60.5 ± 7.0

Radiation, chemotherapy

Aerobic exercise modality: Continuous. Time: 150 min/w. Frequency: 2 sessions /w. Duration: 12m Intensity: started at 50% of HRmax and increased over the 1st month to 60% to 80% of HRmax

Linear

(5)

de Paulo et al. [49] (2018)

RCT. Single-center

±õ—I±õ±õ

18

18

T: 63.2 ± 7.1

C: 66.6 ± 9.6

Aromatase inhibitor therapy

Aerobic exercise modality: Continuous. Time: 1-2nd week: 20min. 3-36th week: 30min. Frequency: 3 sessions /w. Duration: 36w. Intensity: 1-2nd w: 50–60% HRmax. 3-10th w: 60–65% HRmax. 11-18th w: 65–70% HRmax. 19-28th w: 70–75% HRmax. 20-36th w: 75–80% HRmax

Linear

(10)(11)(12)(13)(17)(19)(20)(21)

Møller et al. [50] (a) (2015)

RCT. Single-center

±õ—I±õ±õ

9

10

°Õ:57.17 ±â¶Ä‰10.51

C: 46.95 ± 9.19

AC & TAX & CYC

Aerobic exercise modality: Continuous & Interval. Time: 60–90 min/ sessions. Frequency: 3 sessions /w. Duration: 12w. Intensity: 95–95% HRmax

Nonlinear

(5)(6)(11)(12)(13)

Møller et al. [50] (b) (2015)

RCT. Single-center

±õ—I±õ±õ

10

10

T: 48.49 ± 8.41

°ä:46.95 ±â¶Ä‰9.19

AC & TAX & CYC

Aerobic exercise modality: Continuous. Time: 30 min/ sessions. Frequency: 5 sessions /w. Duration: 12w. Intensity: 70–75% HRmax

Linear

(5)(6)(11)(12)(13)

Ma et al. [51] (2018)

RCT. Single-center

-

31

33

T: 44 ± 6

C: 44 ± 6

AC

Aerobic exercise modality: Interval. Time: 50 min/ sessions. Frequency: 3 sessions/w. Duration: 16w. Intensity: Work: 90 -95% HRmax. Rest: 50 –70% HRmax

Linear

(5)(22)

Al-Majid et al. [52] (2015)

RCT. Single-center

±õ—I±õ

6

7

T: 52.7 ± 10.7

C: 47.9 ± 10.4

Adjuvant chemotherapy

Aerobic exercise modality: Continuous. Time: 20–40 min/ sessions. Frequency: 1st w: 2 sessions, 2nd-12th w: 3 sessions/w. Duration: 12w. Intensity: 1st w: 40%—50% HRR. 2nd-3rd w: 50%—70% HRR. 4th -12thw: 70%—80% HRR

Nonlinear

(5)

Jones et al. [53] (2013)

RCT. Single-center

0 to IIIA

36

31

T: 56.4 ± 9.6

C: 55.4 ± 7.6

Adjuvant chemotherapy

Aerobic exercise modality: Continuous. Time: 15min for week 1, and then gradually increased minutes of exercise per week to 30 min for weeks 5 through 12. Frequency: 5 sessions/w. Duration: 6m. Intensity: started at 50% HRmax to 60%—80% HRmax

Nonlinear

(21)

Rogers et al. [54] (2009)

RCT. Single-center

I, II, or IIIA

20

19

T: 52 ± 15

C: 54 ± 8

Aromatase inhibitors or selective estrogen receptor modulators

Aerobic exercise modality: Continuous. Time: 40 – 45 min / sessions. Frequency: 1st -2nd week: 3 sessions/w. 3rd-6th week: 4 sessions/w. 7th -12th week: 5 sessions/w. Duration: 12w. Intensity: moderate intensity

Nonlinear

(6)(12)(16)

Dieli-Conwright et al. [55] (a) (2021)

RCT. Single-center

±õ—I±õ±õ; Hispanic ethnicity

28

24

T: 46.9 ± 10.2

C: 46.7 ± 10

Surgery, radiation, chemotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min of aerobic exercise per session by 16th w. Frequency: 3 sessions/w. Duration: 16w. Intensity: 65%-80% HR max

Nonlinear

(5)

Dieli-Conwright et al. [55] (b) (2021)

RCT. Single-center

±õ—I±õ±õ; Non-Hispanic ethnicity

19

22

T: 55.6 ± 10.5

C: 55.9 ± 10.3

Surgery, radiation, chemotherapy

Aerobic exercise modality: Continuous. Time: 5 min every 3–4 weeks resulting in a total of 45 min of aerobic exercise per session by 16th w. Frequency: 3 sessions/w. Duration: 16w. Intensity: 65%-80% HR max

Nonlinear

(5)

Nuri et al. [56] (2012)

RCT. Single-center

I to IIIB

14

15

T: 58.27 ± 6.31

C: 58.27 ± 6.31

Hormone therapy

Aerobic exercise modality: Continuous. Time: Start with 25 min and increase by 10 min every 5 weeks. Frequency: 2 sessions/w. Duration: 15w. Intensity: 45%-65% HR max

Nonlinear

(5)(6)(10)(14)(15)(16)(17)(20)

Lahart et al. [57] (2018)

RCT. Single-center

±õ—I±õ±õ

16

16

T: 52.5 ± 10.7

C: 52 ± 8.6

_

Aerobic exercise modality: Continuous. Time: 1st -3rd month: 30 min/sessions. 4th-6th month: > 30 min/sessions. Frequency: 1st -3rd m: 3–5 sessions /w. 4th-6th m: 5–7 sessions /w. Duration: 24w. Intensity: Moderate -vigorous

Nonlinear

(5)

Rogers et al. [58] (2013)

RCT. Single-center

I, II or IIIA

11

9

T: 58 ± 6.1

C: 53.7 ± 13.9

_

Aerobic exercise modality: Continuous. Time: 150 min/w. Duration: 12w. Intensity: Moderate intensity

Linear

(5)(6)(12) (16)

Guinan et al. [59] (2013)

RCT. Single-center

±õ—I±õ±õ

16

10

T: 50.05 ± 8.27

C: 45.05 ± 9.04

Adjuvant hormone therapy and anti-Her2 directed therapy

Aerobic exercise modality: Continuous. Time: 21-42min /sessions. Frequency: 21-42min /sessions. Duration: 8w. Intensity: 30%—75% HRR

Nonlinear

(15)(17)(18)(19)(20)

Herrero et al. [60] (2011)

RCT. Single-center

±õ—I±õ

8

8

T: 50.05 ± 8.27

°ä:45.05 ±â¶Ä‰9.04

CFM

Aerobic exercise modality: Continuous. Time: Gradually increased from 20 to 30min per session. Frequency: 2 sessions /w. Duration: 8w. Intensity: Gradually increased from 30 to 75% HRR

Nonlinear

(5)(10)(11)(12)

Ligibel et al. [61] (2008)

RCT. Single-center

±õ—I±õ±õ

42

40

T: 52 ± 9

°ä:53 ±â¶Ä‰9

chemotherapy and/or radiation therapy

Aerobic exercise modality: Continuous. Time: 90 min / sessions. Frequency: 2 sessions /w. Duration: 16w. Intensity: Moderate intensity

Linear

(6)(10)(12)(14)(15)(16)

Lahart et al. [62] (2016)

RCT. Single-center

±õ—I±õ±õ

40

40

T: 52.4 ± 10.3

C: 54.7 ± 8.3

Radiation therapy and/or chemotherapy

Aerobic exercise modality: Continuous. Time: 30 min / sessions. Frequency: 5 sessions /w. Duration: 12w. Intensity: Moderate intensity

Linear

(6)(10)(12)(17)(18)(19)(20)

DeNysschen et al. [63] (2010)

RCT. Single-center

±õ—I±õ±õ

36

30

T: 48.7 ± 8.4

C: 49.5 ± 9.5

Chemotherapy

Aerobic exercise modality: Continuous. Time: 20–30 min / sessions. Frequency: 3–5 sessions /w. Duration: 4-6m. Intensity: 60–80% VO2peak

Nonlinear

(10)(12)(13)

Kim et al. [27] (a) (2021)

Cohort trial. Single-center

-

11,154

7410

T: 50.9 ± 9.6

C: 53.1 ± 10.1

Radiotherapy,Ìýcardiotoxic chemotherapy,Ìýaromatase inhibitor, Tamoxifen

Aerobic exercise modality: Continuous. Time: 1–499 MET-mins/week. Duration: 5 year. Intensity: Low

Linear

(1)(2)(3)

Kim et al. [27] (b) (2021)

11,110

7410

T: 50.9 ± 9.4

C: 53.1 ± 10.1

Aerobic exercise modality: Continuous. Time: 1–499 MET-mins/week. Duration: 5 year. Intensity: Medium

Linear

(1)(2)(3)

Kim et al. [27] (c) (2021)

10,101

7410

T: 50.6 ± 8.4

C: 53.1 ± 10.1

Aerobic exercise modality: Continuous. Time: 1–499 MET-mins/week. Duration: 5 year. Intensity: High

Linear

(1)(2)(3)

Jones et al. [28] (a) (2016)

Cohort trial. Single-center

±õ—I±õ±õ

747

741

T: 56.6 ± 10.5

C: 58.7 ± 10.4

Surgery, chemotherapy, radiotherapy, tamoxifen or aromatase inhibitor

Aerobic exercise modality: Continuous. Duration: 5 year. Intensity-Time: 5.4 MET-h/week

Linear

(1)(2)(4)

Jones et al. [28] (b) (2016)

741

741

T: 57.2 ± 10.3

C: 58.7 ± 10.4

Aerobic exercise modality: Continuous. Duration: 5 year. Intensity-Time: 16.3 MET-h/week

Linear

(1)(2)(4)

Jones et al. [28] (c) (2016)

744

741

T: 55.4 ± 10.5

C: 58.7 ± 10.4

Aerobic exercise modality: Continuous. Duration: 5 year. Intensity-Time: 40 MET-h/week

Linear

(1)(2)(4)

  1. (1) Cardiovascular disease events
  2. (2) Coronary artery disease
  3. (3) Stroke
  4. (4) Heart failure
  5. (5) VO2max
  6. (6) BMI
  7. (7) the Reynolds risk score
  8. (8) the metabolic syndrome z-score
  9. (9) the Framingham Risk Scor
  10. (10) Weight
  11. (11) Fat mass
  12. (12) BF%
  13. (13) Lean mass
  14. (14) Hip circumference
  15. (15) Waist circumference
  16. (16) Waist-to-hip ratio
  17. (17) Triglyceride
  18. (18) Total Cholesterol
  19. (19) LDL–C
  20. (20) HDL–C
  21. (21) CRP
  22. (22) LVEF(%)
  23. WÌýweek, MÌýmonths, HRmax: maximal heart rate