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
Sun L, Parikh RB, Hubbard RA, Cashy J, Takvorian SU, Vaughn DJ, Robinson KW, Narayan V, Ky B.: Assessment and management of cardiovascular risk factors among US Veterans with prostate cancer JAMA Network Open : 2021.
Clasen SC, Shou H, Freedman G, Plastaras JP, Taunk NK, Kevin Teo BK, Smith AM, Demissei BG, Ky B.: Early cardiac effects of contemporary radiation therapy in breast cancer patients. Int J Radiat Oncol Biol Phys : 2020.
Levine L, Arany Z, Kern-Goldberger A, Koelper N, Lewey J, Sammel MD, Elovitz MA, Ky B.: Soluble Flt1 levels are associated with cardiac dysfunction in Black women with and without severe preeclampsia. Hypertens Pregnancy : 2020.
Kula AJ, Katz R, Zelnick LR, Soliman E, Go A, Shlipak M, Deo R, Ky B, DeBoer I, Anderson A, Christenson R, Seliger SL, Defilippi C, Feldman HI, Wolf M, Kusek J, Shafi T, He J, Bansal N.: Association of circulating cardiac biomarkers with electrocardiographic abnormalities in chronic kidney disease. Nephrol Dial Transplant : 2020.
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 : 2020.
Demissei BG, Fan Y, Qian Y, Cheng HG, Smith AM, Shimamoto K, Vedage N, Narayan HK, Scherrer-Crosbie M, Davatzikos C, Ky B: Left ventricular segmental strain and the prediction of cancer therapy related cardiac dysfunction European Journal of CV Imaging : 2020.
Dixon SBN, Howell CR, Lu L, Plana JC, Joshi VM, Luepker RV, Durand JB, Ky B, Lenihan DJ, Jefferies JL, Green DM, Ehrhardt MJ, Mulrooney DA, Folse TE, Partin RE, Santucci AK, Howell RM, Srivastava DK, Hudson MM, Robinson LL, Ness KK, Armstrong GT: Cardiac biomarkers and association with subsequent cardiomyopathy and mortality among adult survivors of childhood cancer: A report from the St. Jude Lifetime Cohort. Cancer : 2020.
Krishnan S, Narayan HK, Greedman G, Plastaras JP, Maity A, Demissei B, Smith AM, Berman AT, Cengel K, Levin W, Swisher-McClure S, Feigenberg S, Ky B: Early Changes in Physical Activity and Quality of Life with Thoracic Radiation Therapy in Breast Cancer, Lung Cancer, and Lymphoma International Journal of Radiation, Biology and Physics : 2020.
Ganatra S, Dani SS, Shah S, Asnani A, Neilan TG, Lenihan D, Ky B, Barac A, Hayek SS, Leja M, Herrmann J, Thavendiranathan P, Fradley M, Bang V, Shreyder K, Parikh R, Patel R, Singh A, Brar S, Guha A, Gupta D, Mascari P, Patten RD, Venesy DM, Nohria A, Resnic FS: Management of Cardiovascular Disease During Coronavirus Disease (COVID-19) Pandemic Trends Cardiovasc Med : 315-325,2020.
Narayan HK, Xu R, Forsch N, Govil S, Lukuridze D, Lindenfeld L, Adler E, Hegde S, Tremoulet A, Ky B, Armenian S, Omens J, McCulloch AD.: Atlas-based measures of left ventricular shape may improve characterization of adverse remodeling in anthracycline-exposed childhood cancer survivors: a cross-sectional imaging study. Cardiooncology 8 : 6:13,2020.
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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