Cardiac and Vascular Health Clinical Academic Group

Introduction

Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Cardiac and Vascular Health Clinical Academic Group (CVH CAG) focuses on reducing the burden of cardiac and vascular diseases within the communities that we serve - locally, nationally and globally. The Group aims to do so through a broad program of research, translation, education and advocacy that takes an inclusive approach where all SPHERE partners, consumer and community representatives and relevant industry partners, are welcome and are pro-actively engaged.

Mission

The mission of the CVH CAG is to reduce the burden of cardiac and vascular diseases within the communities that we serve - locally, nationally and globally. The CVH CAG aims to do so through a broad program of research, translation, education and advocacy that takes an inclusive approach where all SPHERE partners, consumer and community representatives and relevant industry partners, are welcome and are pro-actively engaged.

Research

Four priority areas were identified and subsequently referred to as CVH CAG Areas of Focus:

Focus Area 1 – Mechanisms and causes of disease

The overarching goal of this focus area is to understand mechanisms underlying cardiovascular disease to discover novel drug targets and undertake preclinical development of new therapies for clinical translation. Positive outcomes from these studies will then proceed to translation and implementation by members of Focus Areas 2- 4.

Focus Area 2 – Identifying best treatments

This will build on the work of Focus Area 1 as well as develop opportunities arising elsewhere to rigorously assess potential interventions for Cardiac and Vascular disorders, through high-quality randomised controlled trials. Work on novel therapies will be included, sometimes in partnership with industry, as well as investigations of novel uses for existing treatments.

Focus Area 3 – Optimising uptake of proven therapies

There are many proven therapies for Cardiac and Vascular disorders that are poorly implemented across Australia and globally. This area will focus on finding better ways to deliver proven therapies (implementation science) as well as improving translation across SPHERE partner organisations.

Focus Area 4 – Protecting the community from CV disease

Drivers of Cardiac and Vascular disease such as poor diet, inactivity and obesity may be best addressed through community and population-based initiatives. This focus area will undertake research and advocacy to define and implement the best ways to implement initiatives.

Partnership

All our research is conducted via respected research centres, including

• University of NSW (UNSW)
• University of Technology Sydney (UTS)
• Western Sydney University (WSU)
• Centre for Eye Health (CFEH)
• Garvan Institute of Medical Research (Garvan)
• Ingham Institute for Applied Medical Research (IIAMR)
• Neuroscience Research Australia (NeuRA)
• The George Institute for Global Health (TGI)
• Victor Chang Cardiac Research Institute (VCCRI)
• South Eastern Sydney Local Health District (SESLHD)
• South Western Sydney Local Health District (SWSLHD)
• St Vincent's Health Network (SVHN)
• Sydney Children’s Hospital Network (SCHN)

Cardiac and Vascular Health CAG Consumer and Community Involvement Group

The CVH CAG has established a Consumer and Community Involvement (CCI) Group to collaborate in the design of our research projects and to empower the community to make a difference.

CCI Group Aims

• To provide a consumer and community perspective on current and future activities of the SPHERE CVH CAG.
• To assist in identifying gaps, barriers, strengths and opportunities for improvement in the engagement of consumers and the community in health research undertaken by the CAG.
• To provide direct advice to research activities undertaken by members of the CAG.
• To provide input into Cardiac and Vascular Health Research proposed for the CAG.

Cardiac and Vascular Health CAG Grants Awarded

The following members and projects have been awarded funding from the CVH CAG.

E/MCR Seed Grant Scheme (2019)

• Dr Anjalee Thanuja Amarasekera - Western Sydney University

“Does vitamin D deficiency cause frailty through its effects on early stage vascular dysfunction (endothelial dysfunction)? – Interplay between vitamin D deficiency, chronic inflammation and sarcopenia.”

• Dr Carinna Hockham - The George Institute for Global Health

“Pilot phase of an adaptive trial of interventions to improve adherence to secondary prevention medication following an acute myocardial infarction.”

• Dr Sergey Tumanov - The Victor Chang Cardiac Research Institute

“Generation of a novel mouse model of atherosclerotic plaque rupture and thrombosis for mechanistic and therapeutic discoveries.”

COVID-19 Response Grant Scheme (2020)

• A/Prof Sally Inglis - University of Technology Sydney

“Tele-PC Study – Telehealth: examining cardiovascular patient and clinician experiences of receiving and delivering care during the pandemic to inform 21st Century cardiac care.”

• Dr James Otton - Liverpool Hospital

“Does COVID-19 have important long-term cardiac sequelae?”

Impact

The CVH CAG was newly formed in early 2019 and has since been working on innovative and effective ways to make a positive impact on the community that we serve. The full impacts of research being translated into clinical and community application will mature with time. Some early indications of success include:

TeleClinical Care – Cardiac – A Smartphone-Centric Digital Ecosystem to Improve Patient Outcomes and Reduce Hospital Burden

The objective of the TeleClinical Care program is to improve patient outcomes and reduce hospital burden through the development of an interoperable smartphone-centric digital ecosystem that supports patients in their transition from acute cardiac care back into the community. To do this, a new system comprising smartphone app and back-end server, running data analytics for patient management and health-risk stratification, has been designed to be integrated into the existing health service delivery models within the collaborating partner organisations. The system is called TeleClinical Care – Cardiac (TCC-Cardiac).

The prototype for the smartphone-centric TCC-Cardiac was designed by Dr Sze-Yuan Ooi and Prof Nigel Lovell in a collaboration between the Prince of Wales Hospital (POWH) and the Graduate School of Biomedical Engineering (GSBmE) at UNSW respectively. A pilot study confirmed app feasibility in a clinical context.

2019 selected publications with high scientific impact:

• Perkovic V, Jardine MJ, Neal B, Bompoint S, Heerspink HJL, Charytan DM, … Mahaffey KW; CREDENCE Trial Investigators. Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy. New England Journal of Medicine 2019;380(24):2295-2306. doi:10.1056/NEJMoa1811744.

• Rosenstock J, Perkovic V, Johansen OE, Cooper ME, Kahn SE, Marx N, … McGuire DK; CARMELINA Investigators. Effect of Linagliptin vs Placebo on Major Cardiovascular Events in Adults With Type 2 Diabetes and High Cardiovascular and Renal Risk: The CARMELINA Randomized Clinical Trial. Journal of the American Medical Association 2019;321(1):69-79. doi:10.1001/jama.2018.18269.

• Farbehi N, Patrick R, Dorison A, Xaymardan M, Janbandhu V, Wystub-Lis K, Ho JW, Nordon RE, Harvey RP. Single-cell expression profiling reveals dynamic flux of cardiac stromal, vascular and immune cells in health and injury. Elife 2019;8:e43882. doi:10.7554/eLife.43882.

• Stanley CP, Maghzal GJ, Ayer A, Talib J, Giltrap AM, Shengule S, Wolhuter K, Wang Y, Chadha P, Suarna C, Prysyazhna O, Scotcher J, Dunn LL, Prado FM, Nguyen N, Odiba JO, Baell JB, Stasch JP, Yamamoto Y, Di Mascio P, Eaton P, Payne RJ, Stocker R. Singlet molecular oxygen regulates vascular tone and blood pressure in inflammation. doi:10.1038/s41586-019-0947-3. Nature 2019;566:548-552. 

• Moreau JL, Kesteven S, Martin E, Lau KS, Yam MX, O'Reilly VC, del Monte-Nieto G, Baldini A, Feneley MP, Moon AM, Harvey RP, Sparrow DB, Chapman G, Dunwoodie SL. Gene-environment interaction impacts on heart development and embryo survival. Development 2019;146:4. doi:10.1242/dev.172957.

Team

The CVH CAG includes internationally recognized experts ranging from basic sciences, clinical trials and implementation research to public health and health services research.

Our Leadership Group