## 4 Discussion
Furthermore, between 26% and 93% of patients with arsenic trioxide show a prolonged QT interval, and many develop life-threatening ventricular tachyarrhythmias [54]. As a result, chemotherapy-induced cardiotoxicity has been associated with cardiovascular diseases such as myocardial dysfunction, heart failure, coronary artery disease, arrhythmias, arterial hypertension, thromboembolic disease, peripheral vascular disease, pulmonary hypertension, and pericardial complications [9; 55]. In this context, clinical trials in breast cancer survivors based on pharmacological strategies (e.g., beta-blockers, angiotensin-converting enzyme inhibitors, etc.) have shown some benefits in the treatment of cardiovascular disease, but also adverse effects [8]. A rowing-based training program offers a non-pharmacological therapy that can safely contribute to achieving the goals proposed by the American College of Sports Medicine (ACSM), which recommends that cancer survivors perform at least 150 min of moderate physical activity or 75 min of vigorous exercise, as well as incorporating strength training, twice a week [56]. Reviews, such as that by [PERSON] et al. [10], suggest that aerobic exercise has a moderate effect on improving cardiac function in women with breast cancer, consistent with findings in disease-free populations. Furthermore, [PERSON] et al. [8] after reviewing published studies, found that 16 weeks of aerobic and resistance training can reduce the risk of cardiovascular disease by 15% in Hispanic and Latina breast cancer survivors (at greater risk than the rest of the population of developing this type of disease). Rowing is an activity that combines the benefits of aerobic exercise and strength training and can have a beneficial effect on cardiovascular health in female breast cancer survivors [48]. In this study, we can see a directly proportional relationship between cardiorespiratory capacity, heart rate, and blood pressure in female rowers who participated in both training groups. Better cardiorespiratory capacity improves the heart's ability to maintain function and pump blood with less effort [57]. Exercise can also improve the regulation of the autonomic nervous system, reducing the activity of the sympathetic nervous system (which increases blood pressure and heart rate) and increasing that of the parasympathetic nervous system (which decreases heart rate) [9; 26]. Our study showed an overall improvement of 9-10 beats less at rest after 12 weeks of training. In addition, exercise-induced improvement of endothelial function [8] may lead to improved arterial health contributing to the prevention of diseases such as hypertension. As we can see, after 24 weeks of rowing training, diastolic blood pressure decreased overall by 10%, while systolic blood pressure decreased by 15%. Moreover, these results were more prominent in the SSR group rowing on a sliding seat boat than in the FSR group, which rowed on a fixed seat boat. In our case, we have used rowing as a novel discipline since, prior to our studies, there was no literature on this activity, which, like dragon boating, is conducted on water. Despite being a minimally injurious social sport that exercises the entire body through symmetrical movement, rowing does not have the same tradition as dragon boating [40; 58]. Furthermore, our country has a strong tradition of rowing, not only at the competitive Olympic level (sculling) but also deeply rooted in coastal culture and tradition (fixed seat rowing). This is why we distinguished these two groups. On the other hand, the risk of lymphedema following axillary surgery, such as axillary lymph node dissection, is a significant concern for breast cancer patients [59]. Engaging in physical activities, including rowing, poses potential risks and benefits. Rowing, which involves repetitive upper body movements and considerable exertion, can potentially exacerbate lymphedema due to increased fluid accumulation and stress on the lymphatic system.