Table 2.

Future Directions in Modulation of CVD with Precision Medicine.

Phenogrouping Delineate the time course of therapy-induced changes in cardiovascular morphology and function and manifestation of clinical events. Perform epidemiological studies to assess the relationship between CVD risk factors, self-reported physical activity, and CVD-specific mortality. Utilize novel CVD assessment techniques incorporating systemic, organ, cellular, and genetic testing. This would allow for in depth cardiovascular profiling with subsequent grouping of individuals with related comorbidities and pathophysiologies.

Precision Exercise Therapy Compare varying doses and combinations of precision exercise therapy for use in preventive and treatment strategies. Establish most effective timing (before, during, or following therapy) to perform exercise training, and the optimal exercise intensity required to modulate CVD. Perform basket trials with discovery and validation cohorts using phenogrouping techniques.89 Basket trials are predicated on the hypothesis that the presence of a phenotype predicts response to an intervention independent of cancer type (e.g. HER2 +/−). Such trials could illustrate that with an appropriately paired target and therapy, large numbers of patients are not required to identify therapeutic efficacy.