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Bonnie Ky, MD, MSCE

Associate Professor of Medicine
Department: Medicine

Contact information
Hospital of the University of Pennsylvania
11-105 Smilow Center for Translational Research
3400 Civic Center Boulevard
Philadelphia, PA 19104
Office: 215-573-6606
Fax: 215-746-7415
Education:
BS (Chemical Engineering )
Massachusetts Institute of Technology, 1995.
MD (Medicine)
University of Pennsylvania, 2001.
MSCE (Clinical Epidemiology)
University of Pennsylvania, 2009.
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Description of CVI 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, Carver JR, Getz K, Armenian SH, Liu P, Ky B: Changes in Cardiovascular Biomarkers with Breast Cancer Therapy and Associations with Cardiac Dysfunction. N/A January 2019 Notes: Submitted January 2019.

Getz KG, Sung L, Ky B, Gerbing RB, Leger K, Barz A, Sack L, Woods WG, Alonzo T, Gamis A, Aplenc R. : Occurrence of Treatment-Related Cardiotoxicity and its Impact on Outcomes among Children Treated on the AAML0531 Clinical Trial: A Report from the Children’s Oncology Group. Journal of Clinical Oncology 37(1): 12-21, 2019.

Demissei BG, Freedman G, Feigenberg S, Plastaras JP, Maity A, Smith AM, McDonald C, Sheline K, Simone CB, Lin L, Carver JR, Liu P, Zhang L, Bekelman JE, Ky B.: Early changes in cardiovascular biomarkers with contemporary thoracic radiation therapy for breast cancer, lung cancer and lymphoma International Journal of Radiation, Biology and Physics November 2018 Notes: manuscript accepted, in press.

DiLorenzo MP, Hwang WT, Goldmuntz E, Ky B,* Mercer-Rosa L* (*co senior authors): Diastolic Dysfunction in Tetralogy of Fallot: Comparison of Echocardiography with Catheterization. Echocardiography 35(10): 1641-1648, October 2018.

Brown JC, Troxel AB, Ky B, Damjanov N, Zemel BS, Rickels MR, Rhim AD, Rustgi AK, Courneya KS, Schmitz KH: : Effects of Exercise on Circulating Tumor Cells among Patients with Resected Stage I-III Colon Cancer PLOS One 13(10): e0204875, October 2018.

Demissei BG, Finkelman B, Hubbard RA, Smith AM, Narayan HK, Narayan V, Waxman AJ, Domchek SM, Shah P, Ky B: Distinct Phenotypes of Cardiovascular Function in Response to Cardiotoxic Breast Cancer Therapy. Journal of the American College of Cardiology October 2018 Notes: Manuscript accepted.

Schaffer K, Panneerselvam N, Loh KP, Herrmann R, Kleckner I, Dunne RF, Lin P, Heckler CE, Gerbino N, Bruckner LB, Storozynsky Ky B, Mohile SG, Mustian KM, Fung C: A Systematic Review of Randomized Controlled Trials of mHealth Exercise Interventions in Cancer Patients During and After Treatments. Journal of the National Comprehensive Cancer Network A Systematic Review of Mobile Health Exercise Interventions in Patients with Cancer September 2018 Notes: Manuscript accepted.

Upshaw JN, O’Neill A, Carver J, Dimond E, Denlinger C, Kircher S, Wagner L, Ky B, Brell J: Fluoropyrimidine cardiotoxicity: time for a contemporaneous appraisal. Clinical Colorectal Cancer August 2018 Notes: epub ahead of print.

Zhang KW, Finkelman BS, Gulati G, Narayan HK, Upshaw J, Narayan V, Plappert T, Englefield V, Smith AM, Zhang C, Hundley WG, Ky B: Abnormalities in Three-Dimensional Left Ventricular Mechanics with Anthracycline Chemotherapy are Associated with Systolic and Diastolic Dysfunction. Journal of the American College of Cardiology Imaging 11(8): 1059-1068, August 2018.

DiLorenzo MP, Wang Y, Ky B, Elci O, Goldmuntz E, Mercer-Rosa L: Longitudinal Changes in Right Ventricular Function in Tetralogy of Fallot in the Initial Years after Surgical Repair Journal of the American Society of Echocardiography 31(7): 816-821, July 2018.

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Last updated: 03/06/2019
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