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
Fanaroff AC, Orr JA, Anucha C, Kim E, Rareshide C, Echevarria M, Rodarte S, Kassabian M, Balasian E, Ky B, Volpp KGM, Armenian S.: A randomized controlled trial of gamification to increase physical activity among black and Hispanic breast and prostate cancer survivors: Rationale and design of the ALLSTAR clinical trial. Am Heart J 280 : 42-51,2025.
Nikolova AP, Ky B: Immune Checkpoint Inhibitors Myocarditis: The Nuts and Bolts JACC Heart Fail 12 (10): 1794-6,2024.
Nain P, Stabellini N, Makram OM, Rast J, Yerraguntla S, Gopu G, Bhave A, Seth L, Patel V, Jiang S, Malik S, Shetewi A, Montero AJ, Cullen J, Agarwal N, Wang X, Ky B, Baldassarre LA, Weintraub NL, Harris RA, Guha A.: Adverse social determinants of health elevate uncontrolled hypertension risk: a cardio-oncology prospective cohort study JNCI Cancer Spectr 8 : pkae064,2024.
Avis NE, Levine BJ, Klepin HD, Mihalko SL, Brubaker PH, Moore T, Ladd AC, Dent SF, Hackney MH, Ky B, Ntim WO, Wagner LI, Weaver KE, Hundley WG; UPBEAT study team.: The impact of non- and anthracycline-based chemotherapy on fatigue in breast cancer survivors: results from WF-97415 Support Care Cancer 32 : 528,2024.
Kim K, Kim MM, Skoufos G, Diffenderfer ES, Motlagh SAO, Kokkorakis M, Koliaki I, Morcos G, Shoniyozov K, Griffin J, Hatzigeorgiou AG, Metz JM, Lin A, Feigenberg SJ, Cengel KA, Ky B, Koumenis C, Verginadis II.: FLASH Proton Radiation Therapy Mitigates Inflammatory and Fibrotic Pathways and Preserves Cardiac Function in a Preclinical Mouse Model of Radiation-Induced Heart Disease Int J Radiat Oncol Biol Phys 119 (4): 1234-1247,2024.
Mabudian L, Reding K, D'Agostino RB Jr, Heiston EM, Bellissimo MP, Olson K, Ntim WO, Klepin HD, Dressler EV, Moore T, Jordan JH, O'Connell NS, Ladd A, Weaver KE, Ky B, Wagner LI, Hackney MH, Lesser GJ, Hundley WG; UPBEAT Study Team.: The relationship between body composition and left ventricular performance in women with breast, lymphoma, or sarcoma cancer Cardiooncology 10 : 34,2024.
Reding KW, Szewczyk W, D'Agostino RB Jr, O'Connell NS, Vasbinder A, Bellissimo MP, Lucas AR, Sheppard VB, Sutton AL, Ky B, Lesser GJ, Hundley WG.: Black-White Disparities in Submaximal Exercise Capacity Reductions in Breast Cancer Survivors: A Prospective Cohort Study JACC CardioOncol 6 : 467-469,2024.
Demissei BG, Ko K, Huang A, Lee DJ, Doucette AG, Smith AM, Wilcox NS, Reibel J, Sun L, Agarwal M, Haas NB, Hollis G, Shpilsky JE, Takvorian SU, Vaughn DJ, Chen J, Hubbard RA, Powell-Wiley T, Yancy C, Narayan V, Ky B.: Social Determinants of Health Mediate Racial Disparities in Cardiovascular Disease in Men With Prostate Cancer JACC CardioOncol 6 : 390-401,2024.
Leger KJ, Absalon MJ, Demissei BG, Smith AM, Gerbing RB, Alonzo TA, Narayan HK, Hirsch BA, Pollard JA, Razzouk BI, Getz KD, Aplenc R, Kolb EA, Ky B, Cooper TM.: Cardiotoxicity of CPX-351 in children and adolescents with relapsed AML: a Children's Oncology Group report Front Cardiovasc Med 11 : 1347547,2024.
Patel RB, Silvestry FE, Komtebedde J, Solomon SD, Hasenfuß G, Litwin SE, Borlaug BA, Price MJ, Kawash R, Hummel SL, Cutlip DE, Leon MB, van Veldhuisen DJ, Rieth AJ, McKenzie S, Bugger H, Mazurek JA, Kapadia SR, Vanderheyden M, Ky B, Shah SJ.: Atrial Shunt Device Effects on Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction: The REDUCE LAP-HF II Randomized Clinical Trial JAMA Cardiol 9 : 507-522,2024.
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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