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

Demissei BG, Hubbard RA, Zhang L, Smith AM, Sheline K, McDonald C, Narayan V, Domchek SM, DeMichele A, Shah P, Clark AS, Bradbury A, Getz K, Armenian SH, Liu P, Ky B: Changes in Cardiovascular Biomarkers with Breast Cancer Therapy and Associations with Cardiac Dysfunction Journal of the American Heart Association 9 (2): e014708,2020.

Cascino GJ, Voss WB, Canaani J, Altman JK, Foran JM, Litzow MR, Tallman MS, Rigolin V, Akhter N: Two-Dimensional Speckle-Tracking Strain Detects Subclinical Cardiotoxicity in Older Patients Treated for Acute Myeloid Leukemia Echocardiography 36 (11): 2033-2040,2019.

Bansal N, Zelnick L, Shlipak MG, Anderson A, Christenson R, Deo R, deFilippi C, Feldman H, Lash J, He J, Kusek J, Ky B, Seliger S, Soliman EZ, Go AS: Cardiac and Stress Biomarkers and Chronic Kidney Disease Progression: The CRIC Study Clinical Chemistry 65 (11): 1448-1457,2019.

Bansal N, Zelnick L, Go A, Anderson A, Christenson R, Deo R, Defilippi C, Lash J, He J, Ky B, Seliger S, Soliman E, Shlipak M: Cardiac Biomarkers and Risk of Incident Heart Failure in Chronic Kidney Disease: The CRIC (Chronic Renal Insufficiency Cohort) Study Journal of the American Heart Association 8 (21): e012336,2019.

Bekelman JE, Lu H, Pugh S, Baker K, Berg CD, de Gonzalez AB, Braunstein LZ, Bosch W, Chauhan C, Ellenberg S, Fang LC, Freedman GM, Hahn EA, Haffty BG, Khan AJ, Jimenez RB, Kesslering C, Ky B, Lee C, Lu H, Mishra MV, Mullins CD, Mutter RW, Nagda S, Pankuch M, Powell SN, Prior FW, Schupak K, Taghian AG, Wilkinson JB, MacDonald SM, Cahlon O: Pragmatic randomised clinical trial of proton versus photon therapy for patients with non-metastatic breast cancer: the Radiotherapy Comparative Effectiveness (RadComp) Consortium trial protocol BMJ Open 9 (10): e025556,2019.

Upshaw JN, Finkelman B, Hubbard RA, Smith AM, Narayan HK, Arndt L, Domchek S, DeMichele A, Fox K, Shah P, Clark A, Bradbury A, Matro J, Adusumalli S, Carver JR, Ky B: Comprehensive Assessment of Changes in Left Ventricular Diastolic Function With Contemporary Breast Cancer Therapy JACC. Cardiovascular Imaging 19 (30729-6): 2019.

Vaduganathan M, Hirji SA, Qamar A, Bajaj N, Gupta A, Zaha VG, Chandra A, Haykowsky M, Ky B, Moslehi J, Nohria A, Butler J, Pandey A: Efficacy of Neurohormonal Therapies in Preventing Cardiotoxicity in Patients With Cancer Undergoing Chemotherapy JACC: CardioOncology 1 (1): 2019.

Lamprea-Montealegre JA, Zelnick LR, Shlipak MG, Floyd JS, Anderson AH, He J, Christenson R, Seliger SL, Soliman EZ, Deo R, Ky B, Feldman HI, Kusek JW, deFilippi CR, Wolf MS, Shafi T, Go AS, Bansal N: Cardiac Biomarkers and Risk of Atrial Fibrillation in Chronic Kidney Disease: The CRIC Study Journal of the American Heart Association 8 (15): e012200,2019.

Upshaw JN, Ruthazer R, Miller KD, Parsons SK, Erban JK, O'Neill AM, Demissei B, Sledge G, Wagner L, Ky B, Kent DM: Personalized Decision Making in Early Stage Breast Cancer: Applying Clinical Prediction Models for Anthracycline Cardiotoxicity and Breast Cancer Mortality Demonstrates Substantial Heterogeneity of Benefit-Harm Trade-off Clinical Breast Cancer 19 (4): 259-267.e1,2019.

Cornell RF, Ky B, Weiss BM, Dahm CN, Gupta DK, Du L, Carver JR, Cohen AD, Engelhardt BG, Garfall AL, Goodman SA, Harrell SLacy, Kassim AA, Jadhav T, Jagasia M, Moslehi J, O'Quinn R, Savona MR, Slosky D, Smith A, Stadtmauer EA, Vogl DT, Waxman A, Lenihan D: Prospective Study of Cardiac Events During Proteasome Inhibitor Therapy for Relapsed Multiple Myeloma Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology 37 (22): 1946-1955,2019.

View all publications

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