Jason Au
University of Waterloo
Arterial health throughout cancer treatment and exercise rehabilitation in women with breast cancer
#Cardiovascular #Oncology #Sports Medicine #Women's Health
How will the SphygmoCor® technology enable, enhance, or accelerate your research?
The SphygmoCor XCEL will be used for all lab-based vascular measurements. We have experience with similar vascular monitoring tools, but have not previously used SphygmoCor products. In our view, the SphygmoCor line of products will enhance our data pipeline with established, out-of-the-box solutions for vascular measurement that requires minimal signal processing knowledge from our exercise and research staff. We are particularly interested in the utility of the CONNEQT Pulse devices for at-home vascular measurement. While we are confident in our ability to assess arterial health in a highly-controlled lab environment, we recognize and take value in the potential for ‘office’ vascular measurements that are more reflective of the day-to-day vascular exposure of patient populations. In the proposed study, we link CONNEQCT Pulse measurements to contextual psychological and stress outcomes and plan to analyze the data gated to recent chemotherapy, radiation therapy, or exercise training sessions using the provided Data Services. The richness of this data will provide important contextual information for exactly when arterial function changes in day-to-day life of cancer patients, which we have not been able to study with currently available products. We look forward to making the switch to SphygmoCor products as we re-evaluate our vascular measurement tools in the next life cycle of equipment in our research group.
Executive Summary
Chemotherapy and radiation therapy during cancer treatment increases future cardiovascular disease (CVD) risk, with CVD now being the leading cause of death in breast cancer survivors. Exercise training has been proposed as a powerful intervention that can improve outcomes during treatment, though the chronic benefit to arterial health has not been investigated in detail. This project aims to determine 1) differences in the arterial profile between women with breast cancer undergoing cancer treatment and age-matched controls; 2) the impact of a supervised 12-week individualized exercise training program on arterial health; and 3) the utility of at-home vascular monitoring for CVD monitoring throughout cancer treatment and exercise countermeasures. This study will advance our knowledge on the cardiovascular changes that coincide with the treatment of breast cancer and to explore interventions that alleviate cardiovascular risk burden in a community setting.
Research Setting
The research will take place at the Center for Community, Clinical and Applied Research Excellence (CCCARE), which is an integrated community exercise center and research environment. The project will be led by Dr. Jason Au (cardiovascular exercise physiology) and Dr. Marina Mourtzakis (cancer muscle metabolism), both of whom hold multi-year Canadian federal grants for the study of human physiology and mentor a combined 12 high quality research trainees. Co-investigator Dr. Sheereen Harris will support remote monitoring of patient experiences with Ecological Momentary Assessment analysis, adding context to at-home monitoring of vascular function. This proposal will be led by a MSc trainee (J. Jasiak), who has previous experience with multi-site randomized controlled trials in women with atrial fibrillation at the Ottawa Heart Institute. Day-to-day management of exercise regimes and patient recruitment will be facilitated by CCCARE research staff, drawing from continuous rolling recruitment of adults with cancer into the START FIT program. Data will be managed by Dr. Au’s cardiovascular exercise physiology lab, who has 10 years of exercise in blood flow (vascular and cardiac ultrasound) and pressure wave analysis (applanation tonometry, aortic pressure-flow relationships, arterial stiffness, and augmentation index). Dr. Au’s trainees are trained in human vascular data collection and require minimal training to ensure high quality signals from SphygmoCor equipment. Secondary outcomes from the proposal will be facilitated from a Canada Foundation for Innovation infrastructure grant, which supports two GE Medical Systems ultrasounds (VIVID iq and S70N), as well as an open-platform ultrasound coded for advanced engineering solutions.