Description of Research Expertise
Cardiotoxicity from cancer therapy is detectable, preventable and treatable. This is the focus of Dr. Ky’s research program. Cancer therapies are becoming increasingly effective at killing cancer, but these treatments also have toxic side effects, resulting in a growing population of cancer patients and survivors with heart disease. In our lab, we are studying innovative strategies to understand the changes in heart function that occur with common cancer therapies, and how we can apply these methods to understand an individual patient’s risk of developing heart disease and heart failure. Our goals are to bring these exciting research findings to the clinic and continue our mission of delivering state-of-the-art, evidence-based medicine to cancer patients and survivors regionally and nationally. We highlight 3 recent discoveries from our lab below.
How breast cancer therapy affects heart function. In a recent paper published in Circulation, we rigorously and comprehensively define the precise changes that occur with heart function over time in breast cancer patients treated with doxorubicin, trastuzumab and radiation. We found that with these cancer therapies, there are modest, but persistent declines in heart function, even at 3 years post treatment exposure. We also determined that afterload, or blood pressure, is a major determinant of this adverse remodeling. These findings might suggest that aggressive blood pressure control is critical in mitigating a patient’s risk of developing heart dysfunction. We have proposed new trials to test this hypothesis.
How innovative new imaging tools can predict heart damage with cancer therapy. We are also interested in discovering new strategies to predict the risk of subsequent heart damage in cancer patients. In two separate manuscripts published in the Journal of American College of Cardiology Imaging, we have used 2-dimensional and 3-dimensional ultrasound techniques in order to more precisely and deeply understand how the heart functions. We have discovered that early changes in 2D and 3D circumferential strain, or deformation, are associated with the risk of developing cardiotoxicity with anthracyclines.
How simple blood tests – using new markers – can predict heart damage with cancer therapy. We are also studying the role of new blood markers of oxidative stress – and how they can predict who will develop heart damage with anthracycline chemotherapy. These findings were published in the Journal of the American College of Cardiology. We are now testing in a clinical trial how these blood markers can be used to understand why statins might protect the heart and who may benefit the most from statins when receiving anthracycline chemotherapy.
Selected Publications
Sturgeon KM, Smith AM, Federici EH, Kodali N, Kessler R, Wyluda E, Cream LV, Ky B, Schmitz KH: Feasibility of a tailored home-based exercise intervention during neoadjuvant chemotherapy in breast cancer patients BMC Sports Sci Med Rehabil 14 (1): 31,2022 .
Selvaraj S, Hu R, Vidula MK, Dugyala S, Tierney A, Ky B, Margulies KB, Shah SH, Kelly DP, Bravo PE: Acute Echocardiographic Effects of Exogenous Ketone Administration in Healthy Participants J Am Soc Echocardiography 35 (3): 305-311,2022.
McNerney KO, Oranges K, Seif AE, Oshrine B, Ky B, Lin KY, Getz KD, Aplenc R: Acute Left Ventricular Dysfunction Following Gemtuzumab Ozogamicin in Two Pediatric AML Patients J Pediatr Hematol Oncol 44 (2): e507-e511,2022.
Thompson EW, Demissei BG, Smith AM, Brahmbhatt P, Wang J, Clark A, DeMichele A, Narayan V, Shah P, Sun L, Lefebvre B, Fradley MG, Carver JR, Tang WHW, Ky B: Paraoxonase-1 Activity in Breast Cancer Patients Treated with Doxorubicin with or without Trastuzumab JACC Basic to Translational Science 7 (1): 1-10,2021.
Freyer CW, Fradley M, Madnick D, Carver JR, Frey NV, Gill SI, Ky B, Luger SM, Marin ME, McCurdy SR, O'Quinn R, Perl AE, Stadtmauer EA, Loren AW.: Characterization of Pericarditis Following Allogeneic Hematopoietic Cell Transplant Transplantation and Cellular Therapy 27 (11): 934.e1-934.e6,2021.
Goodman R, Chirinos JA, Ky B, Mazurek JA, Smith KA, Palevsky HI, Fritz JS, Pugliese SC, Kawut SM, Al-Naamani N: Systemic arterial properties in pulmonary hypertension Pulm Circ 11 (4): 20458940211055684,2021.
Wilcox NS, Demissei BG, Smith AM, Carver JR, Zhang L, Liu P, Januzzi JL, Ky B: Sustained Increases in IGFBP-7 Following Doxorubicin in Breast Cancer Patients J Am Coll Cardiol CardioOnc 3 (3): 444-446,2021.
Jung JW, Mille MM, Ky B, Kenworthy W, Lee C, Yeom YS, Kwag A, Bosch W, MacDonald S, Cahlon O, Bekelman JE, Lee C: Application of an automatic segmentation method for evaluating cardiac structure doses received by breast radiotherapy patients Physics and Imaging in Radiation Oncology 23 (19): 138-144,2021.
Bansal N, Zelnick LR, Soliman E, Anderson A, Christenson R, DeFilippi C, Deo R, Feldman HI, He J, Ky B, Kusek J, Lash J, Seliger S, Shafi T, Wolf M, Go AS, Shlipak MG; CRIC Study Investigators: Change in Cardiac Biomarkers and Risk of Incident Heart Failure and Atrial Fibrillation in CKD: The Chronic Renal Insufficiency Cohort (CRIC) Study Am J Kidney Dis 77 (6): 907-919,2021.
Dreyfuss AD, Goia D, Shoniyozov K, Shewale SV, Velalopoulou A, Mazzoni S, Avgousti H, Metzler SD, Bravo PE, Feigenberg SJ, Ky B, Verginadis II, Koumenis C: A Novel Mouse Model of Radiation-Induced Cardiac Injury Reveals Biological and Radiological Biomarkers of Cardiac Dysfunction with Potential Clinical Relevance Clinical Cancer Research 27 (8): 2266-2276,2021.
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Academic Contact Information
Hospital of the University of Pennsylvania
11-105 Smilow Center for Translational Research
3400 Civic Center Boulevard
Philadelphia,
PA
19104
Phone: 215-573-6606
Patient appointments: 800-789-7366