New screening tool being developed for childhood cancer survivors at risk for cardiac complications

October 6, 2016 | by Katie Neith

 

Armenian-Gharib-Rosen Steven T. Rosen (l), Morteza Gharib (m) and Saro Armenian (r)

 

For the nearly half a million childhood cancer survivors in the United States today, the consequences of chemotherapy and radiation at a young age can show up years after initial treatment — with one of the most serious side effects being heart failure. And while these long-term risks are known, this population typically no longer receives follow-up care from their oncologists, so early signs of heart problems often go undetected.
 
“On one hand, we have a cure rate [of childhood cancers] that exceeds 80 to 90 and, in some cases, even 95 percent. But on the other hand, 5, 10, 15 years later, you’re dealing with a health condition that is much more deadly than their primary cancer,” said Saro Armenian, D.O., M.P.H., associate professor in the Department of Population Sciences and director of the Childhood Cancer Survivorship Program at City of Hope, at the  “Partners in Innovation,” a symposium given by the Caltech and City of Hope Biomedical Research Initiative held on Sept. 27.
 
Over the past eight years, physicians and scientists from these two institutions have collaborated on innovative research that addresses complex problems in disease control and treatment. In one recent project, together with Morteza Gharib, Ph.D., the Hans W. Liepmann Professor of Aeronautics and Bioinspired Engineering and director of the Graduate Aerospace Laboratories at Caltech, Armenian has helped develop a simple tool built by Gharib’s lab that can screen childhood cancer patients — along with other at-risk populations — for early indicators of heart disease, without having to return to their oncologist.
 
“The reality of survivors of childhood cancers … is that not everybody is being actively followed up in these large medical centers,” said Armenian. “It’s very easy for the very specific and unique issues that need to be picked up earlier to not be addressed.”    
 
Standard heart health follow-up care for childhood cancer survivors includes echocardiogram and even cardiac MRI, expensive and time consuming procedures that can only be done at a medical center. But with Gharib and Armenian’s new device, called Vivio, measurements that reveal similar information can be made at home. Vivio could eventually cost approximately eight dollars. It noninvasively measures the ejection fraction of a patient’s heart, or the efficiency of the heart to pump blood. Vivio can then be paired with an iPhone to send the information it has gathered directly to a physician who can evaluate the measurements for a deficiency that would indicate a problem very early on.
 
Preliminary results from studies that Armenian has done to compare Vivio results with those from echocardiography and cardiac MRI have shown the device to be just as accurate as the advanced techniques.
 
“The technology is out of this world — accessible, hand-held information that you could actually get back from patients in real time,” said Armenian. “This really has the potential to revolutionize how we take care of our patients today.”
 
The Vivio device and related software is in the testing stages of development. Once validated, says Armenian, the technology will be evaluated in much larger groups of at-risk cancer and noncancer populations.
 
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