Research Summary

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Dr. Jassal’s research focuses on the complementary use of multimodality non-invasive cardiovascular imaging in the assessment of heart failure syndromes. Using a combination of echocardiography (ultrasound of the heart), cardiac CT (computed tomography), and CMR (cardiac MRI), the Cardiovascular Imaging Laboratory at the St. Boniface Albrechtsen Research Centre is dedicated to translational research in the fields of Cardio-Oncology, Women’s Heart Health, and Sudden Cardiac Death.

1. EMPACT-BC study (Empagliflozin in the prevention and treatment of doxorubicin and trastuzumab mediated cardiotoxicity in breast cancer). Breast cancer is a major public health concern in Canada. Doxorubicin and Trastuzumab (DOX+TRZ) are two of the most common anti-cancer drugs used in the treatment of breast cancer. While these two anti-cancer drugs improve survival in the breast cancer setting, they may also increase the risk of developing heart failure. Approximately 1 in 4 women with breast cancer are at risk of developing heart failure due to DOX+TRZ, affecting over 8000 women annually in Canada. In the present “EMPACT-BC” study, we will explore the role of the medication “Empagliflozin” in both preventing and treating heart failure caused by DOX+TRZ. Once we obtain this important information from our murine model, we will translate these basic science findings into a multi-centre randomized controlled trial to further investigate the preventative and treatment effects that Empagliflozin may have in individuals with breast cancer. This innovative study will enhance the quality of “heart health” in women with breast cancer.
2. CANFLAX study (Can flax “milk” prevent broken hearts in women with breast cancer?) As Manitoba continues to be one of the top flaxseed (FLX) producers in the world, there is increasing public awareness about the importance of consuming this whole grain commodity in the prevention of cancer and cardiovascular disease. Given that women with breast cancer are at risk of developing chemotherapy-induced heart failure, FLX has demonstrated a promising capacity to prevent this adverse outcome. Pizzey Ingredient’s FLX “milk” is a breakthrough advancement for dietary FLX, providing an efficient and delicious way to consume over 30 g of FLX on a daily basis. FLX “milk”, with its cardioprotective components, including omega-3 fatty acid, alpha-linolenic acid, and plant lignans, is a new alternative in this expanding global market of non-dairy “milk” products. The purpose of the CANFLAX study is to establish FLX “milk” as an effective method of preventing heart failure in women with breast cancer undergoing anthracycline-based chemotherapy. Researching the health benefits of FLX “milk” in this study will help generate: i) an increase in consumer interest; ii) an increase in the demand for FLX; and iii) an increase in FLX acreage within Manitoba. Overall, Manitoba-produced FLX “milk” is an ideal product to prevent broken hearts in women with breast cancer.
3. EXACT 2.0 (Exercise to prevent anthracycline-based cardio-toxicity in individuals with breast cancer). This past year, 27,000 Canadian women were diagnosed with breast cancer. Although significant advances in the battle against breast cancer have resulted in improved morbidity and mortality among women with breast cancer, certain chemotherapy drugs such as anthracyclines (AC) are notorious for causing heart failure. Discovering novel ways to reduce the damaging effects of AC chemotherapy without interfering with the anti-cancer efficacy remain at the forefront of our research. Recent pre-clinical studies have shown that aerobic exercise (AE) performed before or during AC chemotherapy can protect the heart from the damaging effects of these anti-cancer agents. However, the benefits of AE have not been demonstrated in women receiving cancer treatment in the clinical setting. As such, this study seeks to understand the potential benefits of a home-based AE program on the cardiovascular profile in women with breast cancer treated with AC chemotherapy. Patients will be randomly assigned to either the AE or the standard of the care control group. Women with breast cancer assigned to AE will receive a 12-week, home-based exercise program. Contemporary cardiac imaging modalities will be used to assess cardiac function throughout the EXACT 2.0 study. The primary goal of this study is to elucidate how an AE program affects: 1) changes in heart structure (ultrasound of the heart); 2) cardiac electrical activity (ECG); and 3) peak oxygen consumption (VO2 max.). Given that anthracycline-based chemotherapy continues to be routinely used, this study is an invaluable first step to protecting the hearts of women with breast cancer.

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