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Principal Investigator: Justin McNair Canada
Organization: VIRGINIA COMMONWEALTH UNIVERSITY
Fiscal Year: 2024
Award: $149,049
Funding agency: National Heart Lung and Blood Institute
PROJECT SUMMARY
This K23 project will prepare the Principal Investigator, Justin M. Canada, PhD, to develop as an
independent clinical/translational researcher who is expert in a novel form of cardiopulmonary exercise stress
measurement – cardiovascular magnetic resonance imaging (MRI) – to identify factors that reduce peak
oxygen consumption (VO2) in patients with heart failure. Peak VO2 reflects peak exercise capacity, a prime
determinant of outcomes among patients with cardiovascular disease (CVD). This noninvasive methodology
does not require intravenous contrast or ionizing radiation, eliminating possible side effects among patients in
poor health. It also accurately measures exercise-associated cardiac output—a fundamental contributor to
overall exercise capacity—that can be targeted with therapeutic interventions to improve overall peak exercise
capacity.
This project is a collaborative multi-disciplinary effort among oncologists, exercise physiologists, biomedical
engineers, and cardiovascular experts to address an important issue in the emerging field of cardio-oncology.
The proposal focuses on patients receiving allogeneic hematopoietic stem cell transplantation (HCT) for
hematologic malignancies. Treatment-associated reductions in peak VO2 can exclude candidates from life-
saving HCT. Among survivors of hematologic malignancies, reduced peak VO2 is associated with impaired
quality of life and elevated risk of death not related to relapse. At present, there is no reliable method to identify
those at risk for these serious adverse events.
In addition to a strong, supportive environment that includes international experts, the largest HCT program
in Virginia, and state-of-the-art equipment co-located within the Cancer Center that serves the HCT
community, the proposal is buttressed by highly supportive preliminary data and a robust career development
plan for Dr. Canada. This plan provides mentored training in the translational fundamentals of MRI theory:
conduct, interpretation, and MRI application in cardiovascular and cardio-oncology clinical management. This
includes expertise in the technical aspects, analysis, interpretation, and utilization of an innovative exercise
stress-associated cardiovascular MRI technique to discern the mechanism of reduced exercise capacity in
other heart failure syndromes.
This patient-oriented mentored research training plan incorporates a highly innovative technique and an
excellent training environment to develop and test a methodology that identifies the causes of reductions in
peak exercise capacity, a primary determinant of HCT outcomes. The outstanding mentor team will guide the
Candidate’s progress in professional milestones (publications and presentations) and oversee his continued
exposure to responsible conduct of research training. At completion of this K23, Dr. Canada will be well-
qualified to contribute meaningfully to an emerging field of growing research interest.
Terms: <AML - Acute Myeloid Leukemia><Acute Myeloblastic Leukemia><Acute Myelocytic Leukemia><Acute Myelogenous Leukemia><Address><Allogenic><Assessment instrument><Assessment tool><Biomedical Engineering><Body Weight decreased><Canada><Cancer Center><Cancer Treatment><Cancers><Cardiac><Cardiac Output><Cardiopulmonary><Cardiovascular><Cardiovascular Body System><Cardiovascular Diseases><Cardiovascular Organ System><Cardiovascular system><Clinical><Clinical Management><Clinical Oncology><Clinical Trials><Collection><Communities><Coupled><Data><Development Plans><Disease><Disorder><Doctor of Philosophy><Early Diagnosis><Elderly><Eligibility><Eligibility Determination><Environment><Equation><Equipment><Evaluation><Exclusion><Exercise><Exercise Tolerance><Exposure to><Feasibility Studies><Future><Gait speed><Gases><Goals><HSC transplantation><Health><Heart Vascular><Heart failure><Hematologic Cancer><Hematologic Malignancies><Hematologic Neoplasms><Hematological Malignancies><Hematological Neoplasms><Hematological Tumor><Hematopoietic Cancer><Hematopoietic Stem Cell Transplant><Hematopoietic Stem Cell Transplantation><Iatrogenic Cancer><Imaging Procedures><Imaging Technics><Imaging Techniques><Impairment><Individual><International><Intravenous><Investigators><Ionizing Electromagnetic Radiation><Ionizing radiation><K23 Award><K23 Mechanism><K23 Program><Life><MR Imaging><MR Tomography><MRI><MRIs><Magnetic Resonance><Magnetic Resonance Imaging><Malignant Hematologic Neoplasm><Malignant Neoplasm Therapy><Malignant Neoplasm Treatment><Malignant Neoplasms><Malignant Tumor><Measurement><Measures><Medical Imaging, Magnetic Resonance / Nuclear Magnetic Resonance><Mentored Patient-Oriented Research Career Development Award><Mentored Patient-Oriented Research Career Development Award (K23)><Mentors><Methodology><Methods><Morbidity><Morbidity - disease rate><Muscle><Muscle Tissue><Myocardial depression><Myocardial dysfunction><NMR Imaging><NMR Tomography><Nuclear Magnetic Resonance Imaging><O element><O2 element><Oncologist><Oncology><Oncology Cancer><Outcome><Oxygen><Oxygen Consumption><Patients><Peripheral><Ph.D.><PhD><Phenotype><Physical Performance><Physical activity><Physicians><Play><Principal Investigator><Procedures><Protocol Screening><Publications><QOL><Qualifying><Quality of life><Radiation-Ionizing Total><Relapse><Reproducibility><Research><Research Personnel><Research Training><Researchers><Risk><Role><Scientific Publication><Scientist><Serious Adverse Event><Severe Adverse Event><Stress><Survivors><Syndrome><Techniques><Testing><Therapeutic Intervention><Therapy Related Malignant Neoplasm><Therapy Related Malignant Tumor><Therapy-Associated Cancers><Therapy-Related Cancer><Time><Training><Transplant Recipients><Transplantation><Treatment-Associated Cancer><Treatment-Related Cancer><Virginia><Weight Loss><Weight Reduction><Zeugmatography><acute granulocytic leukemia><acute myeloid leukemia><advanced age><adverse event risk><anti-cancer therapy><bio-engineered><bio-engineers><bioengineering><biological engineering><body weight loss><cancer therapy><cancer-directed therapy><cardiac MRI><cardiac dysfunction><cardiac failure><cardiac function><cardiac imaging><cardiac magnetic resonance imaging><cardiac scanning><cardiovascular disorder><career development><circulatory system><co-morbid><co-morbidity><cofactor><comorbidity><curative intervention><curative therapeutic><curative therapy><curative treatments><death risk><design><designing><disability><early detection><elderly patient><enthusiastic atmosphere><enthusiastic environment><exercise capacity><exercise intolerance><exercise physiologist><exhaustion><frailty><function of the heart><functional status><geriatric><heart dysfunction><heart function><heart imaging><heart output><heart scanning><hematopoietic cell transplantation><hematopoietic cellular transplantation><hematopoietic progenitor cell transplantation><improved><improved outcome><innovate><innovation><innovative><interest><intervention therapy><ionizing output><leukemia><leukemia treatment><leukemic therapy><malignancy><mortality><mortality risk><multidisciplinary><muscular><neoplasm/cancer><novel><older patient><patient centered><patient oriented><programs><responsible research conduct><senior citizen><serious adverse experience><serious adverse reaction><side effect><social role><success><supportive atmosphere><supportive environment><targeted drug therapy><targeted drug treatments><targeted therapeutic><targeted therapeutic agents><targeted therapy><targeted treatment><temporal measurement><temporal resolution><theories><time measurement><translational investigator><translational researcher><translational scientist><transplant><transplant patient><transplant therapy><transplant treatment><transplantation therapy><transplantation treatment><wt-loss>