Current Research

    1. A

      • Aboriginal and Torres Strait Islander quantitative research approaches to descriptive research inquiry into cardiovascular disease

        Ms Joanne Luke
        Ms Joanne Luke
        Researcher: Ms Joanne Luke
        Years Funded: 2015 - 2018

        This project will explore quantitative research methodologies and techniques, and then apply these to describe contexts of cardiovascular disease for Indigenous Australians. Victorian and national population based health surveys will be analysed.

        This research will provide ways forward in modelling Indigenous Australian health data, and in modelling data where there are complex relationships between various clinical, social and environmental variables.

        This research will offer resistance against quantitative research techniques that lack Indigenous Australian perspectives, stereotype Aboriginal and Torres Strait Island people, lack context and ignore Indigenous Australian realities.

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      • Activation and rejuvenation of endogenous cardiac stem cells

        Dr James Chong
        Dr James Chong
        Researcher: Dr James Chong
        Years Funded: 2015 - 2016

        Heart failure rates are increasing exponentially in Australia and worldwide. This burden of heart failure is underpinned by the heart’s limited capacity for self-repair after injury. This limitation could be overcome by stimulating newly discovered stem cells (unspecialised ‘parent’ cells that give rise to new, specialised cells) residing within the adult heart itself.

        Dr Chong and colleagues recently discovered a cardiac colony forming stem cell population and have found that the molecule ‘platelet derived growth factor’ (PDGF), activates and rejuvenates these resident heart stem cells thereby improving heart function after injury.

        This project hopes to aid the progression of this promising therapy, from the laboratory into the clinic where thousands of patients could benefit.

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      • Advancing obesity prevention in Australia by applying system science

        Professor Steven Allender
        Professor Steven Allender
        Researcher: Professor Steven Allender
        Years Funded: 2013 - 2017

        The World Health Organization Collaborating Centre for Obesity Prevention (WHOCC) at Deakin University, where this project is based, has led the world in the design of community based interventions (CBI) to prevent obesity.

        Professor Steven Allender will expand on existing evidence to examine the system factors essential to population level obesity prevention. A system refers to an interconnected set of elements that is organised in a way that achieves something – such as an education system – and produces its own pattern of behaviour over time. He will analyse high quality data from multiple successful interventions and evaluate a cluster randomised controlled trial of an $81 million system-based intervention.

        Steven will examine high quality data from multiple CBIs to establish how system-based approaches were associated with the success or failure of intervention. He will test the hypothesis that key system elements are associated with intervention success in preventing childhood obesity.

        Following the successful WHOCC trials, the Victorian Government agreed that the $81 million National Partnership Agreement on Preventive Health would take an explicitly system-based approach. Victoria is using systems theory as the basis for a large cluster randomised trial for childhood obesity prevention. Building on the lessons learned in the first part of his project, Steven will test the hypothesis that ‘a whole of system intervention reduces childhood obesity’.

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      • Altering the rehabilitation environment to improve stroke survivor activity (AREISSA)

        Mr Neil Spratt
        Mr Neil Spratt
        Researcher: Mr Neil Spratt
        Years Funded: 2014 - 2016

        Despite higher levels of activity being associated with better stroke recovery, stroke patients on most rehabilitation units spend the majority of their day inactive and alone.

        Laboratory models have suggested that environmental enrichment, such as providing equipment, facilitates physical, cognitive and social activity. This promotes rewiring of the brain after stroke and has been found to significantly enhance functional recovery.

        Preliminary work on the use of environmental enrichment for stroke patients using individual (e.g. iPods, word puzzles) and communal (e.g. access to interactive gaming, computer, books/newspapers, jigsaws) enrichment in a rehabilitation unit has shown that it encourages patients to be more active. Greater activity during rehabilitation has numerous benefits, the most important of which is achieving better functional recovery, and subsequently, greater independence.

        Neil's project, 'Altering the rehabilitation environment to improve stroke survivor activity' (AREISSA), is a Phase II trial involving four rehabilitation units that will determine the safety, feasibility and patient and staff acceptability of this model of environmental enrichment during stroke rehabilitation.

        Results from AREISSA will be used to inform a future large scale cluster randomised controlled trial to determine the effect of environmental enrichment on stroke recovery and stroke survivor quality of life.

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      • Atherosclerosis and intrauterine inflammation

        Ms Maria Nguyen
        Ms Maria Nguyen
        Researcher: Ms Maria Nguyen
        Years Funded: 2013 - 2015

        Atherosclerosis, a hardening of the arteries, is a chronic inflammatory disease that begins during early life and manifests clinically as cardiovascular disease (CVD) in adulthood.

        The significant time lag between the onset of atherosclerosis and its complications in adulthood provides a window of opportunity for early detection and potential therapeutic intervention. Atherosclerosis may initiate during foetal life, particularly in the presence of under-nutrition and maternal factors such as high cholesterol, smoking, diabetes and obesity. As each of these factors has also been linked with increased inflammation, a subclinical inflammatory process before birth may be the trigger for early development of atherosclerosis.

        Despite the potential association, no studies have yet investigated the direct effect of intrauterine inflammation (inflammation within the uterus) on the development of early atherosclerosis. One proposed mechanism through which intrauterine inflammation may influence the development of atherosclerosis is via epigenetic modifications (changes in the proteins associated with our DNA). There is emerging evidence to suggest that atherosclerosis and susceptibility to CVD is, at least in part, epigenetically regulated.

        Ms Maria Nguyen's research project will use laboratory models of atherosclerosis and histological chorioamnionitis (inflammation of the foetal membranes) to investigate the effect of intrauterine inflammation on the development of atherosclerosis. It will also assess whether epigenetic modifications play a likely mechanistic role in the early inflammatory origins of atherosclerosis.

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      • Atrial fibrillation and heart failure: exploring determinants of adverse and favourable outcomes

        Dr Liang-han Ling
        Dr Liang-han Ling
        Researcher: Dr Liang-han Ling
        Years Funded: 2015 - 2017

        Heart failure, when the heart muscle is weakened and cannot pump sufficiently, and atrial fibrillation (irregular heartbeat) frequently occur in combination where they are associated with grave outcomes. In particular, refractory heart failure (where symptoms persist, despite drug treatment), stroke, and premature death.

        Treatment is often problematic due to their self-perpetuating nature and the limited availability of effective therapies. Despite their escalating prevalence, the interaction between these two diseases is incompletely defined.

        This project will explore the causes of adverse and favourable outcomes when atrial fibrillation and heart failure are combined; and will examine new strategies for the treatment of this disease complex.

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      • Atrial fibrillation screening by primary care physicians for prevention of stroke

        Professor S. Ben Freedman
        Professor S. Ben Freedman
        Researcher: Professor S. Ben Freedman
        Years Funded: 2015

        Atrial fibrillation is the most common heart arrhythmia (irregular heart beat). It affects almost 5% of people over the age of 65 years, and carries an increased risk of severe stroke. However, as it often has no obvious symptoms, screening is required to detect it.

        Stroke related to atrial fibrillation can be prevented by taking anticoagulants (which prevent harmful blood clots forming), but these medicines are under-prescribed by doctors.

        Our proposed study would use new technology (an iPhone ECG) to screen for previously undetected atrial fibrillation in general practice. We plan to develop innovative electronic decision support for anticoagulant prescription by doctors.

        This will close the gap in identification and treatment of atrial fibrillation, to help prevent stroke.

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      • Aussie salt challenge: a pilot web-based education program to reduce salt intake in school children

        Dr Carley Grimes
        Dr Carley Grimes
        Researcher: Dr Carley Grimes
        Years Funded: 2015

        Recent national data shows that school children consume too much dietary salt and that salt reduction strategies are urgently required.

        This pilot study will assess the effectiveness of a web-based salt reduction education program that aims to lower salt intake among 8–10 year old school children and increase child and parental salt knowledge. Children will actively participate in weekly online interactive education sessions and parents will receive concurrent education materials.

        If this method of online message delivery is effective, it will provide a sustainable education program that could be widely disseminated in the future.

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      • The Australia and New Zealand Fontan Registry: the ideal model to improve the adult life of children born with congenital heart disease

        Associate Professor Yves D’Udekem
        Associate Professor Yves D’Udekem
        Researcher: Associate Professor Yves D’Udekem
        Years Funded: 2014 - 2019

        People born with a single pumping chamber in their heart are at the worst end of the spectrum of congenital heart disease. The Fontan procedure is the last of a series of operations giving them survival to adulthood, but an uncertain future thereafter.

        We have built the largest and the only population-based database of Fontan patients in the world. There are one thousand people, who have had the procedure, currently living in Australia and this will double within 15 years. Half of the patients in the contemporary cohort suffer complications within 10 years of surgery. Transition to adult care sees a third of these patients dropping from the follow-up that would prevent the development of these complications. 

        With the partnership grant, Associate Professor Yves d’Udekem aims to: (1) standardise the follow-up care after Fontan surgery; (2) set up a strategy to improve transition to adult care of all Fontan patients; and (3) study the impact of these strategies on complication rates and costs.

        The project involves all the adult and paediatric units in Australian hospitals that look after congenital heart disease, as well as HeartKids, a charity who provide support to families of children with heart disease. It is the largest project in this field aimed at improving the survival and the quality of life for those with the most severe congenital heart conditions.

        The benefits of this initiative will not be restricted to this growing population of Fontan patients: it will undoubtedly improve the care of all people growing up with congenital heart disease.

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    2. B

      • Benefit of heart failure surveillance in rural communities

        Ms Hong (Hilda) Yang
        Ms Hong (Hilda) Yang
        Researcher: Ms Hong (Hilda) Yang
        Years Funded: 2014 - 2016

        Ms Hong Yang’s research project seeks to define the benefit of a screening program in rural subjects at risk of heart failure (HF) aged 65 years and older with type 2 diabetes, obesity, high blood pressure, past cancer therapy or known cardiac disease (but not existing heart failure). This is an important project because HF is especially difficult to diagnose and manage without echocardiography (ultrasound of the heart), and the availability of this test in rural areas is very limited.

        To demonstrate the benefit of testing, Hong will recruit ‘at risk’ subjects from the community and randomise them for a screening program based on echocardiography. Patients with abnormalities will be entered into a program of cardioprotective therapy, supervised by their general practitioner. 

        She expects echo changes of early HF to occur in 30–50% of at risk subjects. Without the intervention, we would expect 25% of these to proceed onto HF without treatment. With the intervention, we expect 5% to proceed. Through this study, Hong expects to prevent at least 24 people from developing HF. In June 2010, there were 79,100 people aged 65 years and older in Tasmania, which equates to 15.6% of the population. The prevalence of people in this age group with type 2 diabetes, obesity, high blood pressure, past cancer therapy or known cardiac disease is over 25% – roughly 20,000 people (50 times the number in the study). Application of this program on a state-wide basis would avoid heart failure in around 1,200 people.

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      • Better use of proven medications for the prevention or management of cardiovascular disease

        Dr Ruth Webster
        Dr Ruth Webster
        Researcher: Dr Ruth Webster
        Years Funded: 2015 - 2016

        Several medications are available that have been shown to be highly effective in preventing heart disease and stroke, including medications that lower blood pressure and cholesterol and thin the blood.

        However, only about half of those patients at the highest risk of a heart attack or stroke currently take these medications. Simplifying treatments, by reducing the number of pills patients need to take, has been shown to help patients to follow their treatment regimen.

        This research will focus on how to identify patients who will benefit the most from combination pills for the prevention of heart attack and stroke.

        Additionally, using clinical trials, it will assess whether a low dose combination blood pressure lowering pill will improve the treatment of blood pressure and minimise side effects.

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      • Blood vessel stem cell technologies to improve cardiovascular disorders

        Dr Jatin Patel
        Dr Jatin Patel
        Researcher: Dr Jatin Patel
        Years Funded: 2015 - 2016

        Cardiovascular disease is a major cause of disease related deaths and years of life lost. In many patients, blood supply to an essential organ is reduced due to defective arteries that need to be either re-opened or bypassed. However, surgery is not technically feasible for every patient. Stem cells called endothelial progenitor cells (EPCs) offer new hope for these patients.

        Blood vessels, including arteries, are generated in our body through the activity of EPCs. These new vessels can restore circulation in areas affected by cardiovascular disease. However, trials using EPC treatment have been hampered by the lack of clear definition and clinical availability of these cells.

        This study will use a newly patented method that isolates large quantities of EPCs from the placenta, obtained at term following caesarean section. These EPCs will be systematically studied as a ready-to-use product in research models of leg artery closure. In patients this frequently ends with amputation.

        The use of EPCs in the clinic offers exciting new therapeutic possibilities for treating cardiovascular disease.

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      • Building evidence for public health approaches to reduce adult sedentary behaviour

        Dr Josephine Chau
        Dr Josephine Chau
        Researcher: Dr Josephine Chau
        Years Funded: 2015 - 2017

        Australian adults spend large amounts of time each day in sedentary behaviour. Too much sitting has been linked with an increased risk of chronic illness, even in people who are physically active.

        Sitting less may have considerable health benefits, over and above those of being physically active. These benefits may be especially prominent in people who are not active at all, and those with existing cardiovascular disease.

        This research will generate new knowledge about the relationships between sedentary behaviour and cardiovascular health risks and outcomes. It will examine population levels of sedentary behaviour in different groups and identify factors linked with high and low levels of sitting.

        The researchers will develop communication messages and strategies for programs and campaigns about sitting less. Lastly it will test whether different ‘sit less’ strategies are feasible and appropriate for scaling-up into different settings.

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      • Burden and disparities in heart failure: The GAP project

        Associate Professor Andrea Driscoll
        Associate Professor Andrea Driscoll
        Researcher: Associate Professor Andrea Driscoll
        Years Funded: 2015 - 2019

        Heart failure occurs when the heart is unable to pump an adequate supply of blood around the body. Hospitalisations and loss of life associated with heart failure remain high, costing over $1 billion annually in Australia. This significant burden demands continuous improvement in health service management to minimise healthcare costs.

        This project will provide a unique opportunity to determine the costs associated with heart failure and to predict its future burden in Australia.

        Importantly, outcomes will be translated into clinical practice to improve future health service delivery for patients with heart failure and in turn to improve survival and reduce hospital readmissions.

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    3. C

      • Cardiac arrhythmia following kidney transplantation

        Dr Chrishan Nalliah
        Dr Chrishan Nalliah
        Researcher: Dr Chrishan Nalliah
        Years Funded: 2015 - 2017

        Chronic kidney disease (CKD) is increasingly being recognised as a major global public health burden with a prevalence in excess of 10%. CKD patients requiring regular dialysis treatment are at high risk of sudden cardiac death (SCD) and accounts for 20–30% of all deaths in these patients.

        Although these patients have multiple risk factors for arrhythmias (irregular heart beats), traditional risk factors for SCD do not adequately explain or predict those at highest risk.

        We have recently used implantable cardiac monitoring to determine the incidence and characteristics of arrhythmias experienced by CKD patients. We found this group had a high SCD rate but the mechanism was predominantly, and unexpectedly, a slow heart beat (bradycardia) and absence of heart contractions (asystole) rather than ventricular arrhythmia.

        Renal transplantation dramatically improves the expectancy and quality of life of patients with CKD. However, its effect on cardiac arrhythmia burden and type remains unevaluated.

        We aim to characterise changes in arrhythmia type and burden following transplantation by recruiting patients with CKD who are on dialysis while waiting for a kidney transplant. We will also describe changes in heart structure and the electrophysiology responsible for changes in arrhythmia type or burden after kidney transplantation.

        This will have widespread implications for treatment and outcomes of patients undergoing transplantation, and provide insight into arrhythmia in CKD.

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      • Cardiac computed tomography in the assessment of ischaemic heart disease

        Dr Chung-Yao Yu
        Dr Chung-Yao Yu
        Researcher: Dr Chung-Yao Yu
        Years Funded: 2015

        Cardiac computed tomography (CTCA) is an effective imaging technique for ruling out ischaemic heart disease in symptomatic patients. However, uptake in Australia has been slow despite technical improvements that have expanded its accuracy.

        The first arm of Dr Chung-Yao Yu’s PhD focuses on incorporating CTCA into the assessment of patients who present at the emergency department (ED) with chest pain. This method has already been shown to be effective in improving outcomes, however further work is needed to improve the flow of patients through the ED and to reduce waiting times.

        The second arm of the project involves evaluating the use of CTCA to assess blood flow into heart muscle. Acquiring this functional data may improve the diagnostic accuracy of CTCA, reducing the need for invasive coronary angiography. The addition of CT perfusion to measure blood flow in patients where the anatomical information from CTCA is of indeterminate significance will be compared to gold-standard invasive angiography (ICA).

        The third arm of the project will evaluate the capacity of CTCA to predict adverse cardiac events in patients who have undergone a cardiac transplant. Asymptomatic accelerated coronary artery disease is an important cause of morbidity and mortality (illness and death) in heart transplant recipients, and patients are subjected to repeated ICA as part of routine surveillance. Chung-Yao’s study will assess the safety of CTCA replacing ICA for the early diagnosis of blood vessel disease.

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      • Cardiovascular effects of energy drinks

        Dr Belinda Gray
        Dr Belinda Gray
        Researcher: Dr Belinda Gray
        Years Funded: 2015

        There are multiple case reports in the literature indicating that energy drinks can cause life-threatening heart rhythm problems in patients with no previous history of heart disease.

        This research project seeks to investigate the cardiovascular risks of energy drink consumption particularly in patients with inherited heart rhythm problems. We suspect energy drinks and their constituents may cause potentially dangerous heart rhythms in at-risk individuals. The patients who appear to be most at risk are those to whom the drinks are most heavily marketed, i.e. children, teenagers and young adults.

        Identifying what effects these drinks have on the heart's electrical system will help determine those most at risk of dangerous life threatening arrhythmias, or even sudden cardiac death, due to excessive consumption of energy drinks.

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      • Cardiovascular health and anxiety mood problems: CHAMP pilot study

        Dr Phillip Tully
        Dr Phillip Tully
        Researcher: Dr Phillip Tully
        Years Funded: 2015 - 2016

        Depression disorders are disabling in cardiovascular disease (CVD), and interventions have not produced a sizeable impact on CVD or depression.

        Our recent research shows that generalised anxiety disorder commonly co-exists with depression. Anxiety is linked with greater CVD related disability; and CVD patients frequently require cognitive-behavioural therapy.

        This study will assess whether a cognitive-behavioural therapy intervention for generalised anxiety disorder will lead to improvements in mental wellbeing, quality of life and CVD health. It is hoped that the results of this project translate into clinical practice.

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      • Catheter ablation for atrial fibrillation in heart failure

        Dr Sandeep Prabhu
        Dr Sandeep Prabhu
        Researcher: Dr Sandeep Prabhu
        Years Funded: 2014 - 2016

        Heart failure (HF) is a common heart condition whereby the pumping capacity of the heart is significantly reduced. It is the end result of many conditions that weaken the heart muscle. Atrial fibrillation (AF) is a common electrical disturbance of the heart that results in rapid and irregular heart rates and may cause, or significantly worsen, HF. Similarly, HF may cause AF, which in turn may worsen the severity of pre-existing HF. Catheter ablation of AF is a procedure where electric current is delivered to the site of arrhythmias by catheter. This electrically isolates the pulmonary veins, shown to be the source of AF. This can restore and maintain normal rhythm far more effectively than current medications alone. However, it is currently difficult to identify which patients have AF that is causing or significantly contributing to their HF that may therefore benefit from catheter ablation. Patients with HF display a unique pattern of scarring in the heart muscle, capable of being detected by magnetic resonance imaging (MRI). The amount of scarring in the heart muscle appears to be proportional to the degree of reversibility of HF. Thus in patients with AF and HF, Dr Sandeep Prabhu believes that MRI may help identify those whose HF is most likely to improve, or even completely reverse, following catheter ablation.

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      • Cerebrovascular disease and the ageing brain

        Associate Professor Velandai Srikanth
        Associate Professor Velandai Srikanth
        Researcher: Associate Professor Velandai Srikanth
        Years Funded: 2014 - 2017

        Associate Professor Velandai Srikanth specialises in studying vascular (blood vessel) disease of the brain.

        Vascular disease is now recognised as an important risk factor for the occurrence of important brain related health problems that occur in older people – namely cognitive decline, gait decline and falls (commonly referred to as manifestations of brain ageing).

        Through this Future Leader Fellowship, Valandai aims to refine our understanding of the cause and effect relationship between vascular disease (including diabetes mellitus) and brain ageing. He also hopes to identify new and modifiable cardiovascular mechanisms that may be responsible for brain ageing. He will design and test interventions that can reduce the effects of such vascular disease on the brain, and will design ways to efficiently provide care to prevent vascular disease in the brain. 

        Velandai’s ultimate goal is to improve the management of vascular disease to prevent or reduce its harmful effects on the ageing brain, and to provide a better quality of life for ageing people in Australia and elsewhere in the world.

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      • Childcare-based web interventions to improve children’s fruit and vegetable consumption

        Dr Sze Lin Yoong
        Dr Sze Lin Yoong
        Researcher: Dr Sze Lin Yoong
        Years Funded: 2015 - 2017

        Dietary habits established in childhood persist into adulthood. Therefore improving children’s fruit and vegetable consumption is recommended to reduce the development of cardiovascular disease later in life.

        Childcare services are a key setting for interventions to improve children's diets with over 60% of preschool aged children attending care. However less than 10% of childcare services provide sufficient serves of fruit and vegetables to children.

        This study is the first, internationally, to examine the usefulness of a web-based program for supporting services in the provision of fruit and vegetables, and its impact on children's diets. To maximise use, the program will be integrated into childcare mandatory reporting software.

        If effective, this intervention will positively impact on the fruit and vegetable consumption of thousands of Australian children attending childcare services.

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      • Comprehensive risk assessment and management of patients with cancer treatment induced heart failure

        Professor Robyn Clark
        Professor Robyn Clark
        Researcher: Professor Robyn Clark
        Years Funded: 2015

        Cardiotoxicity resulting in left ventricular failure is a devastating outcome of anti-cancer therapy. It is possible that a patient may survive cancer only to develop heart failure, which may carry a higher death rate than cancer.

        The aim of this project is to develop processes that identify patients at risk of heart failure. It also aims to develop evidence based practice guidelines to ensure referral to cancer survivorship programs and/or specialist heart failure programs as needed.

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      • Computed tomography for detection of plaque in heart arteries at risk of future heart attacks

        Dennis Wong
        Dennis Wong Dennis Wong
        Researcher: Dennis Wong

        Heart attack remains one of the major causes of death in Australia. It usually occurs due to rupture of a plaque following cholesterol build-up, in the major heart arteries. Studies using invasive ultrasound have identified some features of plaque that are at high risk of rupture, referred to as 'vulnerable plaque'.

        Recent developments in non-invasive computed tomography (CT) technology have enabled identification of these features. However, no prospective large studies using new generation CT scanners have looked at the association between these plaques and heart attack. In addition, there is currently no evidence to guide clinicians on how to manage vulnerable plaque.

        Dr Dennis Wong will study more than 7,000 patients for up to six years to determine the incidence of heart attack. He aims to correlate the CT features of vulnerable plaque with heart attack before it occurs.

        In a follow-up longer term study, he aims to study the degree of effect of lowering cholesterol on vulnerable plaque and heart attack rates. This will be the first time such a study has been carried out and it could lead to CT emerging as a tool that can identify and determine patient risk of heart attack based on the presence of vulnerable plaque.

        Furthermore, Dennis research will determine whether lowering cholesterol reduces these patients risk of future heart attacks.

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    4. D

      • Decoding gene networks that govern heart development and disease

        Dr Mirana Ramialison
        Dr Mirana Ramialison
        Researcher: Dr Mirana Ramialison
        Years Funded: 2014 - 2018

        One in 100 Australian babies are affected by heart malformations. The heart is a complex organ and its formation is likewise orchestrated by a complex network of genes. Current knowledge of this network is limited.

        Using cutting edge bioinformatics approaches that deal with methods for storing, retrieving and analysing biological data, Dr Mirana Ramialison will draw a comprehensive picture of the genes required to build a healthy heart, and show how they are affected in heart disease.

        Mirana will analyse a range of existing data to generate a unique repository of cardiac network genes. She will then use computer models to reconstruct the interactions between the genes of the network. These interactions will then be validated in zebrafish to verify that the interactions predicted by the computer model are correct.

        This work will lead to the first extensive description of the gene interactions that occur during heart formation and will reveal which gene interactions are altered in congenital heart disease. This will provide new perspectives on network biology-based therapies.

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      • Defining treatment gaps in cardiovascular disease prevention

        Dr Meg Jardine
        Dr Meg Jardine
        Researcher: Dr Meg Jardine
        Years Funded: 2015 - 2016

        The most immediate and effective way to address the burden of cardiovascular disease is to attack the treatment gap for those in whom best evidence therapies are indicated but are not being received. Such an approach will have particularly high impact if targeted to those as high risk, such as people with diabetes or chronic kidney disease. Effective strategies can be developed once there is a clear understanding of the extent and determinants of treatment gaps.
         
        The EXTEND45 study will define treatment gaps in the prevention of cardiovascular events and disease progression, particularly for adults with diabetes and kidney disease. Through a novel linkage program, EXTEND45 will study 250,000 adults from the 45 and Up study, shedding light on cardiovascular disease in contemporary NSW.

        This knowledge will inform the design of strategies targeting treatment gaps, potentially improving cardiovascular health in the short to medium term.

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      • Detection and management of pre-clinical right sided heart failure

        Ms Leah Wright
        Ms Leah Wright
        Researcher: Ms Leah Wright
        Years Funded: 2015 - 2017

        Pulmonary hypertension is when the blood pressure in the lungs is raised. It is a debilitating condition with only 50% of patients surviving three years.

        Tasmania currently has a higher prevalence and incidence of pulmonary hypertension related to structural tissue disease (bone and skin) than other regions in Australian.

        There is a large disease registry that for over 10 years has been aggressively screening and treating patients with a mild onset of this condition. This involves treating patients with therapies that relax and open the blood vessels. This is believed to improve exercise capacity, mobility, blood vessel spasm, right heart function and overall quality of life.

        This project will look at a wide range of aspects of this disease process and determine whether the early treatment strategy improves clinical outcomes, and whether it is cost effective.

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      • Determining the mechanism of atrial fibrillation

        Dr Manaswi Bhupesh Pathik
        Dr Manaswi Bhupesh Pathik
        Researcher: Dr Manaswi Bhupesh Pathik
        Years Funded: 2014 - 2016

        Atrial fibrillation (AF) is the most common cardiac arrhythmia (irregular heartbeat), with a prevalence that increases with age. In patients with structural heart disease AF is associated with a 5% or greater annual risk of stroke and a twofold increase in mortality. The past 10 years has seen the successful development of curative techniques for paroxysmal AF (where the arrhythmia lasts longer than 30 seconds) based on a clear understanding of arrhythmia mechanisms.

        However, in patients with persistent AF (that is unlikely to revert back to normal without treatment) the mechanisms involved and how they vary in different patient populations remain poorly understood. As a result, curative techniques have a low success rate and it is unclear how these procedures should be performed.

        Dr Bhupesh Pathik’s aim is to understand the mechanism of this very common heart rhythm disturbance. It is anticipated that his clinical study will provide detailed information regarding the mechanism of, and underlying atrial substrate for, persistent AF in patients with a range of conditions associated with this arrhythmia. This information is likely to greatly advance our understanding of this arrhythmia and form a foundation on which development of curative and preventative approaches may be tailored.

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      • Determining the mechanisms to prevent detrimental high blood pressure in patients with coarctation

        Dr Melissa Lee
        Dr Melissa Lee
        Researcher: Dr Melissa Lee
        Years Funded: 2015 - 2021

        Coarctation of the aorta is a narrowing of the aorta and usually requires surgical repair within the first days of life.

        Many patients develop high blood pressure (hypertension) early in life, which is difficult to treat and linked to death at a young age. The exact cause of this hypertension is unknown but there is likely an unidentified cascade of neurohormonal factors (molecules related to blood and nerves) underlining it.

        This research will investigate these neurohormonal factors after coarctation repair to determine how best to treat and prevent this hypertension allowing people with a coarctation repair the opportunity to live a full and healthy life.

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      • Developing a language pedometer: measuring the talk time of people with aphasia

        Professor Linda Worrall
        Professor Linda Worrall
        Researcher: Professor Linda Worrall
        Years Funded: 2015

        One of the major impacts of stroke is aphasia,  a language disorder that affects talking, reading, writing and understanding language. Modelled on the highly successful 10,000 steps program, which is aimed at promoting physical fitness, the Communicative Fitness program aims to encourage people with aphasia to talk more.

        This research project aims to develop and test a wearable, neck-attached accelerometer which quantifies speech by detecting vibration of the vocal chords. The accelerometer will be used with CommFit, an iPhone application developed for people with aphasia that tracks talking time and allows users to set talk time goals and log communication activities.

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      • Developing a wireless method to assess coronary artery disease

        Dr Andy Yong
        Dr Andy Yong
        Researcher: Dr Andy Yong
        Years Funded: 2015 - 2018

        Fractional flow reserve (FFR) is a technique used in the cardiac catheterisation laboratory during coronary angiography to evaluate coronary artery disease. Using FFR to guide decisions on whether to perform angioplasty or bypass grafting has been shown to improve outcomes. 

        However, FFR measurement currently requires placing a guidewire with a pressure sensor into the coronary vessel. These specialised wires are expensive and associated with a risk of damaging the arteries which may lead to a heart attack. 

        This project aims to develop a ‘wireless’ method of measuring FFR using computational fluid dynamics of 3D coronary angiography images with novel software. This method will remove the need for a wire – reducing cost and making FFR assessment safer and more accessible.

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      • Diagnosis and treatment of diabetic pulmonary vascular dysfunction

        Dr Andre La Gerche
        Dr Andre La Gerche
        Researcher: Dr Andre La Gerche
        Years Funded: 2015

        Diabetes and heart failure are two of Australias greatest health challenges. Dr Andre La Gerche believes that the potential for the pulmonary circulation where oxygen-depleted blood is carried to the lungs to restrict blood flow, and thereby contribute to heart failure, has been overlooked.

        Andre's research group has extensively studied the role of pulmonary circulation during exercise and noted a disproportionate increase in the work required of the right ventricle (RV), which receives this oxygen depleted blood, as compared with the left ventricle, which receives oxygenated blood from the lungs and pumps it back through the body.

        They have validated a novel echocardiographic technique whereby a greater amount of micro-bubbles passing through the lung vessels (termed 'PTAC') is associated with improved cardiac output, RV function and exercise capacity. Relatively selective pulmonary vasodilators medicines that widen blood vessels have the potential to improve exercise capacity in patients with pulmonary vascular disease and heart failure, but they have not been tested in patients with diabetes. Andre hypothesises that people with diabetes experience pulmonary vascular dysfunction, which may be identified with PTAC and treated with the medicine sildenafil.

        This project will assess 60 people (20 patients with diabetes, 20 without evidence of microvascular disease, and 20 non-diabetic control subjects). It will measure PTAC, pulmonary pressures, resistance and RV function, and determine whether these conditions improve with the use of sildenafil.

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      • Doing old business in a new and innovative way: building healthier families and stronger communities

        Mr Rohan Corpus
        Mr Rohan Corpus
        Researcher: Mr Rohan Corpus
        Years Funded: 2015 - 2017

        This research project looks at health outcomes for Aboriginal and Torres Strait Islander people diagnosed with, and receiving treatment for, cardiovascular disease through the Indigenous Cardiac Outreach Program.

        It aims to determine whether treatment can be improved by delivery of an innovative wellness approach that is people centred, endogenous, indigenous and community determined.

        Mr Corpus hopes to improve cardiovascular health for Indigenous Australians through enhanced community economic stability, improved health outcomes, reduced hospitalisations and allowing sustainable change by building local capacity.

        Read more
    5. E

      • The early life factors that contribute to cardiovascular disease

        Professor David Burgner
        Professor David Burgner
        Researcher: Professor David Burgner
        Years Funded: 2014 - 2017

        Atherosclerosis 'hardening of the arteries' is an inflammatory condition beginning in early life, often before birth, and is the process underlying heart attack and stroke. Atherosclerosis develops silently through childhood, causing CVD in adults. Early life is a potential, but largely ignored, window of opportunity to prevent cardiovascular disease.

        Professor David Burgner's research investigates factors during pregnancy and childhood that drive the early development of atherosclerosis and cardiovascular risk. He has a particular interest in the role of inflammation that may occur in pregnancy (e.g. due to infection and inflammation of the placenta, hypertension or diabetes in pregnancy) and in childhood (e.g. following childhood infection, or due to common chronic inflammatory diseases).

        David uses a variety of research approaches, including large population studies, investigation of infants born following high-risk pregnancies, and studies of children exposed to infection or with inflammatory conditions. His research also includes Kawasaki disease, an inflammatory illness of infants and the most common cause of acquired heart disease in children. He is co-lead of an international research group looking at the genetic basis of this condition.

        Ultimately, his goal is to understand factors that promote early atherosclerosis and cardiovascular risk, develop new treatments and prevention, and to identify those people at greatest risk.

        Read more
      • Early molecular causes of pathological cardiac hypertrophy and failure

        Dr Francine Coehlo-Marques
        Dr Francine Coehlo-Marques
        Researcher: Dr Francine Coehlo-Marques
        Years Funded: 2013 - 2016

        Heart enlargement (cardiac hypertrophy) is a common condition that is associated with increased risk of serious cardiovascular events. Dr Francine Marques and her research group have developed a laboratory model of genetic cardiac hypertrophy, and found that this model suggests that those at risk of genetic cardiac hypertrophy may be born with fewer and smaller cardiac cells than those not at risk.

        Small RNA molecules (called microRNAs or miRNAs) are known to regulate the expression of the genes and contribute to normal heart development, but also disease. MiRNAs are responsive to therapy to reprogram their disease-causing effects.

        Francine has exciting preliminary data that cardiac miRNA expression is significantly altered in neonatal models. She proposes that an increase in the expression of miRNAs, through the regulation of gene expression, leads to a decrease in cardiac cell numbers and size in young heart models. She believes this may be the foundation for the later enlargement of the heart and heart disease.

        Francine’s project will pinpoint abnormalities in DNA sequencing, and miRNA and gene expression, and link these to cardiac cell size and number. Her studies will provide an understanding of the two-way interaction between genes and miRNA that underpin cardiac hypertrophy and allow testing of targeted, brief miRNA-based therapeutic interventions to prevent hypertrophy and its complications.

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      • Echocardiography prediction of sudden cardiac death

        Rebecca Perry
        Rebecca Perry
        Researcher: Rebecca Perry

        Some patients with heart failure are at risk from sudden cardiac death due to a life threatening heart rhythm. This occurs most often in those patients that have only a mild or moderate decrease in the function of the heart pump. For the most part these patients are currently excluded from receiving an internal cardiac defibrillator (an implantable device that can shock a patient out of a life threatening heart rhythm). Having an internal cardiac defibrillator would likely dramatically reduce the risk of sudden cardiac death in this patient population. Evidence would suggest that the patients most likely to suffer from a life threatening arrhythmia have a scar or fibrosis of their heart muscle. Scar or fibrosis is difficult to look at with standard cardiac ultrasound imaging (also known as echocardiography or echo), however a new technology known as strain imaging has the potential to highlight areas of scar or fibrosis in the heart muscle and therefore may be able to better predict those patients that may succumb to sudden cardiac death.

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      • Effectiveness of surgeon performance feedback on improving cardiac surgery

        Professor Christopher Reid
        Professor Christopher Reid
        Researcher: Professor Christopher Reid
        Years Funded: 2015

        The aim of this project is to test the feasibility of a formal feedback program to reduce variation in cardiac surgery performance between hospitals, thereby improving patient outcomes.

        Data collected for the Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) registry will be continually monitored and analysed to identify variation in surgical performance and clinical outcomes including mortality rates, blood product usage, reoperation, kidney failure, wound infection and stroke after cardiac surgery.

        This project aims to reduce variation between hospital units in terms of clinical outcomes after heart surgery and foster staff engagement in improving their own unit's performance.

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      • Effect of giving low-dose colchicine following a heart attack

        Associate Professor Graham Hillis
        Associate Professor Graham Hillis
        Researcher: Associate Professor Graham Hillis
        Years Funded: 2015 - 2016

        Heart attack remains a major cause of death and disability, both in Australia and worldwide. Inflammation of the blood vessel wall (vascular inflammation) is one of the primary triggers for a heart attack. Currently, there are no treatments that reduce the inflammation, meaning patients who survive a heart attack are at high risk of a recurrent event.

        Recent data suggest that low doses of colchicine, a unique anti-inflammatory drug mainly used to treat gout, may reduce vascular inflammation and, therefore, the risk of heart attacks and associated complications.

        This pilot study will test the safety and anti-inflammatory effects of low-dose colchicine when given following a heart attack. If these initial results are promising, the benefits will be assessed fully in a large clinical trial.

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      • The effects of front-of-pack food labelling systems and health claims on consumers food choices

        Professor Simone Pettigrew
        Professor Simone Pettigrew
        Researcher: Professor Simone Pettigrew
        Years Funded: 2014 - 2016

        Escalating obesity rates and the resulting need to encourage people to make healthier food choices has increased the policy focus on food labelling. Large health gains at a population level can be achieved through small dietary improvements, and food labelling is recognised as an important mechanism for improving individuals’ diets.

        Labelling can inform consumers of the nutrients they should actively seek to consume or avoid, and heighten awareness of the diet-disease link. Developing effective food labelling systems is therefore an important element of public health strategy. 

        In the Australian context, a small amount of research has investigated consumers’ ability to use competing front-of-pack labelling systems. However, this research excludes children and does not include the federal government's new star system. There is also minimal research involving newly-approved health claims, especially how they might interact with the star system.

        Professor Simone Pettigrew will address these research gaps by investigating food choices by adults and children when presented with different front-of-pack labels and health claims. She will also investigate how food labelling can be used to favourably influence food choices among consumers of differing socioeconomic status.

        This is particularly important given the tendency for people of lower socioeconomic status to have higher levels of obesity and lower levels of literacy, and hence, potentially, could be most advantaged by food labelling systems that can improve food choices.

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      • Effects of salt on blood vessel function in diabetes

        Dr Sara Baqar
        Dr Sara Baqar
        Researcher: Dr Sara Baqar
        Years Funded: 2014 - 2017

        A major controversy in epidemiology (the study of the patterns, causes and effects of health and disease conditions in defined populations) is whether salt restriction can decrease blood pressure thereby decreasing the death rate from cardiovascular disease or whether salt restriction has potentially harmful effects on other systems in the body that may negate the effects of lowered blood pressure.

        The research team Dr Sara Baqar will work with and others have previously shown that in patients with type 2 diabetes, a low salt diet increases cardiovascular and total mortality. An explanation for this finding could be that a low salt intake may increase sympathetic nervous system (SNS) activity.

        With this Health Professional Scholarship, Sara aims to determine baseline SNS activity and endothelial function (the inner lining of blood vessels) in patients with diabetes consuming a habitual low salt diet. She also hopes to determine whether salt loading reduces SNS activity and improves endothelial function.

        This research will improve our understanding of the effects of dietary salt in people with type 2 diabetes, and will provide further insight into the implications of salt on cardiovascular health.

        Read more
      • Enhancing the use of hypertension guidelines in general practice

        Dr Chinthaka Balasooriya
        Dr Chinthaka Balasooriya
        Researcher: Dr Chinthaka Balasooriya
        Years Funded: 2014 - 2015

        The Guideline Enhancement Tool (GET) is a clinical training tool designed to: a) promote effective use of hypertension guidelines by general practitioners; b) develop clinicians decision-making processes related to hypertension management; and c) enable consideration of contextual factors that influence clinical decisions, to generate recommendations to better tailor the guidelines to general practitioner contexts.

        Dr Chinthaka Balasooriya will evaluate the feasibility and effectiveness of this innovative clinical training tool within a general practice training program. This is particularly significant as hypertension is most frequently managed in general practice. However there is evidence of a significant deficit in the treatment of hypertension and a relatively low uptake of clinical practice guidelines.

        The outcomes of Chinthakas research will enhance general practitioners abilities to make guidelines-based clinical decisions. It will also enhance the feasibility and usefulness of hypertension guidelines in general practice settings. The GET process also has the potential to be extended to enhance clinical decision making in other clinical conditions.

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      • Evaluating innovative web- and smartphone-based interventions to improve health in large populations

        Associate Professor Corneel Vandelanotte
        Associate Professor Corneel Vandelanotte
        Researcher: Associate Professor Corneel Vandelanotte
        Years Funded: 2015 - 2019

        Just 30 minutes of moderate intensity physical activity each day reduces risk factors associated with cardiovascular disease (CVD) and prevents the development of CVD. Yet only 46% of Australians meet the physical activity guidelines.

        Given the enormity of the problem, a solution is needed in which large numbers of people can be motivated to increase activity levels at low cost.

        This research will evaluate web- and smartphone-based physical activity interventions, and will focus on specific subgroups (e.g. people with depressive symptoms or cancer survivors).

        The effectiveness of website components or smartphone apps will be studied. Lastly, the study will aim to translate the outcomes into practice, in collaboration with industry partners.

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      • Evaluation of new biomarkers of thrombosis

        Dr Prahlad Ho
        Dr Prahlad Ho
        Researcher: Dr Prahlad Ho
        Years Funded: 2014 - 2016

        While significant progress in treating cardiovascular disease has been made, our ability to evaluate clotting (thrombotic) risk is still lacking. Currently available tests only provide information about the time to the start of clotting, which only accounts for less than 5% of clot formation, without assessing other crucial aspects, including total clot formation, vessel wall function, platelet function and the role of genetic modulation on thrombosis.

        Recent experimental research has provided new tools to evaluate these aspects of thrombosis. The calibrated automated thrombogram calculates total clot formation, which provides a more accurate global clotting assessment. Similarly, endothelial markers may provide a measure of vessel wall function, which is important for maintaining blood flow. More recently, it has been suggested that small genetic molecules (microRNA) modulate an individual’s response to thrombosis. Yet the challenge remains to translate these experimental tests into routine clinical settings. The main limitation is our understanding of the role and distribution of these biomarkers in the normal setting as well as in clotting and bleeding disease states. 

        Therefore, Dr Prahlad Ho will prospectively study these new biomarkers in normal controls, in patients on anticoagulation and anti-platelet agents, and patients with inherited clotting risk. This will provide a basis for further clinical studies to evaluate the influence of these biomarkers in various disease populations.

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      • Exercise therapy in obesity: identifying the best prescription

        Professor Daniel Green
        Professor Daniel Green
        Researcher: Professor Daniel Green
        Years Funded: 2015 - 2016

        Obesity is a global epidemic which is predicted to affect 700 million people by 2015. In Australian adults, the prevalence of obesity increased 2.5-fold between 1980 and 2000 and currently stands at around 25%. Associated comorbidities include type 2 diabetes and cardiovascular disease (CVD) which produce a huge burden of disability and death.

        However, progression from obesity to diabetes and CVD is preventable. Exercise training has recently emerged as a leading contemporary management strategy to prevent the onset of diabetes and CVD. However the optimal form of exercise for reducing CVD risk remains unknown.

        Professor Daniel Green will assess the independent and combined effects of endurance and resistance training on cardiovascular outcomes in obese adults. He will assess arterial and cardiac health using highly advanced ultrasound techniques, which independently predict cardiovascular events such as heart disease and stroke in high risk patient groups.

        This study has the potential to directly impact clinical management of CVD as it relates to one of the most common and costly risk factors in Australia.

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      • Expanding portion sizes - are we eating what we should be?

        Dr Jason Wu
        Dr Jason Wu
        Researcher: Dr Jason Wu
        Years Funded: 2014 - 2015

        Consumption of excessive portions of food, particularly junk foods low in nutrients but high in calories, has contributed to the obesity epidemic and rising burden of chronic diseases in recent years.

        In order to quantify the magnitude of this problem, we aim to conduct a comprehensive assessment of typical portion sizes currently consumed by Australians, and compare intake levels to Australian government recommendations. We will also evaluate how the serving sizes recommended on food labels by manufacturers stack up against the portion sizes people eat.

        Results from this study will underpin efforts to (1) have more consistent and realistic labelling of portion sizes on food packaging, (2) reduced sizes of food packages marketed for consumption on a single eating occasion, and (3) improved consumer understanding of what is a reasonable portion size

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      • Exploring the meaning and experience of cardiovascular health for people with severe mental illness.

        Ms Teresa Kelly
        Ms Teresa Kelly
        Researcher: Ms Teresa Kelly
        Years Funded: 2014 - 2016

        People who live with severe mental illness die up to 25 years before their peers, mostly from cardiovascular disease (CVD). Risk factors include lifestyle choices (such as smoking, physical inactivity and diet), obesity, psychotropic medication and disparities in healthcare. Despite extensive research, little impact has been made on addressing this longstanding health inequity.

        Evidence based interventions tailored to meet the unique requirements of people living with severe mental illness are critical to addressing the cardiovascular risk and premature mortality experienced by this vulnerable population.

        Informed by evidence based guidelines, Ms Teresa Kelly will examine the meaning and experience of cardiovascular health for people who live with severe mental illness. She will also explore their experience of enablers and barriers to engagement in personal cardiovascular health promotion.

        New knowledge generated from Teresas study will inform the adaptation and/or design of evidence based cardiovascular health promotion interventions that reduce risk factors for CVD and specifically target the unique requirements of people who live with severe mental illness.

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    6. F

      • Fruit and vegetables and blood vessel health

        Associate Professor Jennifer Keogh
        Associate Professor Jennifer Keogh
        Researcher: Associate Professor Jennifer Keogh
        Years Funded: 2013 - 2016

        Robust evidence suggests that diet quality influences health outcomes. A positive association has been shown between a Western diet that is high in fried foods, salty snacks, eggs and meat, and the incidence of heart attack. A high salt diet is also associated with higher risk of stroke and heart disease. Diets high in salt are typically low in fruit and vegetables, and this has important public health implications given the evidence from population studies. The effect of diet on vascular events is greater than the effect on blood pressure alone, as indicated by the long-term outcomes of intervention trials, and this may be mediated by improvement in blood vessel function. Previous studies by Associate Professor Jennifer Keogh and her research team have shown that reducing salt is beneficial for blood vessel function. However, the effects of potassium on blood vessels are less clear. The effects of sodium (salt) and potassium on blood vessels and the interaction of these nutrients are important research questions that need to be clarified. Jennifers study aims to demonstrate the benefits of increased fruit and vegetable consumption on blood vessel health.

        Read more
    7. G

      • Global control of group A streptococcal disease

        Dr Andrew Steer
        Dr Andrew Steer
        Researcher: Dr Andrew Steer
        Years Funded: 2013 - 2016

        Group A streptococcal (GAS) diseases, including rheumatic heart disease, are a major cause of death and disability globally, especially in developing countries. Dr Andrew Steer’s program of research is a comprehensive investigation into the control of GAS diseases, as well as an investigation into how they are caused (pathogenesis) and the genetic susceptibility of people with rheumatic heart disease. He will also evaluate the economic impact of GAS diseases globally.

        In Fiji, Andrew will investigate a novel approach of screening for rheumatic heart disease by nurses using portable echocardiography machines, and the efficacy of mass drug administration in the control of scabies and GAS skin sores versus the standard of care treatment. He will also look into the protective effect of antibodies produced by a GAS vaccine.

        The results will have implications for control of these diseases in populations where they are endemic, including the Indigenous population of Australia and in the Pacific.

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    8. H

      • HealtheMe: an eHealth weight loss intervention for young women

        Dr Melinda Hutchesson
        Dr Melinda Hutchesson
        Researcher: Dr Melinda Hutchesson
        Years Funded: 2014 - 2016

        Cardiovascular disease (CVD) is the leading cause of death for Australian women. Many cases of CVD could be prevented if risk factors such as excess body weight, poor eating habits and low physical activity levels were improved.

        Young adulthood is a period where excess weight is commonly gained. Women gain an average of six kilograms from their early twenties to thirties. Traditional weight loss programs do not appeal to them, as evidenced by low rates of recruitment and completion, as well as worse weight loss results when compared to older adults.

        Dr Melinda Hutchesson will evaluate an evidence-based weight loss intervention (Be Positive Be Healthe) designed specifically for young (18 to 30 years) overweight (BMI 25 to 29.9 kg/m2) women. ‘Be Positive Be Healthe’ differs from traditional interventions as it uses a treatment medium, eHealth, including website, smartphone applications and SMS, that appeals to young women. It is targeted to behaviours and lifestyle factors that lead to weight gain and increased CVD risk in young women. It also provides tailored messages that target their motivations for weight control, determined from consultation with young women.

        The purpose-built Be Positive Be Healthe program aims to help young women to return to a healthy weight, and improve their eating habits and physical activity levels. This will in turn potentially improve CVD risk factors and decrease the number of new cases of CVD in future generations of Australian women.

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      • Heart Failure in young adults following Fontan surgery

        Dr Chin Poh
        Dr Chin Poh
        Researcher: Dr Chin Poh
        Years Funded: 2015 - 2017

        The single ventricle heart is the most severe congenital (existing at birth) heart defect, affecting five in 100,000 births. This was a fatal condition until the ‘atriopulmonary Fontan procedure’ was developed.

        More than 80% of people who have the Fontan procedure survive into adulthood, outliving expectations. However, many suffer from serious complications of heart failure including an irregular heart beat (arrhythmia) and blood clots, with little known about how they should be managed.

        Using the Australia and New Zealand Fontan Registry, Dr Poh will investigate the optimal management of heart failure in these patients, to continue improving their survival and quality of life.

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      • HELP-AF: assessing home-based support and education for people with abnormal heart rhythms

        Professor Prashanthan Sanders
        Professor Prashanthan Sanders
        Researcher: Professor Prashanthan Sanders
        Years Funded: 2011 - 2017

        Atrial fibrillation (AF) is the most common abnormal heart rhythm in the Australian population, and its prevalence is rapidly increasing. People with atrial fibrillation have a significantly impaired quality of life and the medical management of the condition is placing a growing burden on the Australian healthcare system.

        Professor Prashanthan Sanders will conduct a randomised controlled trial to evaluate the effectiveness of a ‘homebased education and learning program for people with atrial fibrillation’ (HELP-AF). In particular, he will determine whether the HELP-AF can improve current standard care by reducing unplanned hospitalisations and improving study participants’ quality of life.

        Prashanthan’s study will help define the best management for AF and will evaluate a model of care that may lead to reduced hospital admissions, improved quality of life and the optimisation of complex medicine regimens for people living with this condition.

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      • High intensity interval training to quit smoking

        Dr Toby Pavey
        Dr Toby Pavey
        Researcher: Dr Toby Pavey
        Years Funded: 2015

        Research shows that up to the age of 55 years, the largest population risk for heart disease in adult women is attributable to smoking (particularly in young women) and physical inactivity.

        The aim of this project is to compare the effects of two exercise interventions, combined with usual care smoking cessation support, on the cessation rates of female smokers wishing to quit. The two exercise interventions are high intensity interval training (HIIT), and lifestyle physical activity (10,000 steps).

        The project will improve our understanding of whether and how exercise or physical activity can promote smoking cessation and its impact on related factors such as cravings and withdrawal symptoms.

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      • HIV-related heart disease

        Cameron Holloway
        Cameron Holloway
        Researcher: Cameron Holloway
        Years Funded: 2012 - 2016

        Infection with human immunodeficiency virus (HIV) continues to be a major public health issue in both the developed and developing world, with a worldwide prevalence of more than 33 million people.

        With the advent of treatment (anti-retroviral therapy), HIV has become a treatable condition. However, individuals with HIV have a high incidence of heart and vascular disease that arises, in part, from complications of long-term treatment. Thus, while heart and vascular diseases are predominantly a result of untreated HIV, therapy is associated with abnormalities in blood fat and sugar, underlying a substantially higher incidence of heart attacks. Therefore, there has been a shift in focus from heart complications caused by the virus to heart and vascular complications associated with its treatment. Recognising the new spectrum of heart abnormalities in patients treated for HIV is an evolving challenge for clinicians.

        As part of his research, Associate Professor Cameron Holloway will bring to Australia a novel technology (cardiac magnetic resonance spectroscopy), which investigates the chemical composition of heart muscle. By investigating the heart and vascular abnormalities associated with the virus and its treatments, the complications of the condition can be determined and appropriate therapy sought.

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      • How can we design places to increase physical activity levels?

        Assistant Professor Hayley Christian
        Assistant Professor Hayley Christian
        Researcher: Assistant Professor Hayley Christian
        Years Funded: 2012 - 2016

        Insufficient physical activity is an important modifiable risk factor for cardiovascular disease (CVD). Additionally, prevention and early intervention can yield significant benefit. Health-promoting behaviours, such as physical activity, that are maintained from childhood to adulthood have a positive effect on adult health. Physically active children and adults are less likely to develop CVD and have improved psychological and emotional health and wellbeing.

        Studies on the impact of the ‘built environment’ (our man-made surroundings including landscaped parks) on physical activity are relatively new, although a growing body of evidence is beginning to emerge. Assistant Professor Hayley Christian will identify the environmental factors that support or inhibit physical activity within the community.

        Hayley will trial a physical activity intervention for adults involving dog walking, and will embark on a new program of research focusing on built environment factors associated with physical activity in children. Her research will help to inform the development of effective interventions for both adults and children that may help to prevent or delay the onset of CVD.

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      • How white blood cells develop in arteries during atherosclerosis

        Dr Peter Psaltis
        Dr Peter Psaltis
        Researcher: Dr Peter Psaltis
        Years Funded: 2015 - 2018

        White blood cells (macrophages) play a key role in the development of plaque build-up and hardening of the arteries (atherosclerosis), which is the underlying cause of most heart attacks and strokes.

        The origins of macrophages have long been thought to be from circulating blood cells called monocytes. However new discoveries show that there are actually stem cells (also known as progenitor or parent cells) for macrophages that exist within the outer lining of blood vessels.

        This project will study whether these local progenitor cells, called AMPCs, are a source of macrophages in atherosclerosis. If so, this could lead to new treatment approaches that target AMPCs to prevent or treat cardiovascular disease.

        Read more
    9. I

      • Identifying the role bone plays in insulin sensitivity and cardiovascular risk

        Dr Itamar Levinger
        Dr Itamar Levinger
        Researcher: Dr Itamar Levinger
        Years Funded: 2014 - 2018

        The bodys regulation of glucose (sugar) in the bloodstream is an important biological function. Problems with this process can lead to obesity, type 2 diabetes and an increased risk of cardiovascular disease (CVD). Physical activity is known to improve glucose control and lower a persons cardiovascular risk, but how it does this is not fully understood.

        It is now known that the bones of the body do not just provide structural support for our muscles. They also help to regulate glucose in our bloodstream through the action of a molecule called undercarboxylated osteocalcin (ucOC).

        Dr Itamar Levinger and his colleagues have found that changes in ucOC after physical activity correlate with lower glucose levels in the bloodstream, and may assist in the reduction of cardiovascular risk. Itamar will test this theory by determining whether ucOC directly or indirectly causes the muscles of the body to increase glucose uptake during exercise.

        Itamar's research will bring new knowledge about the effects of physical activity on glucose control and cardiovascular risk. A better understanding of these mechanisms may allow new medicines to be designed specifically to interact with these pathways, and provide new methods for preventing and managing obesity, type 2 diabetes and CVD.

        Read more
      • Impact of a price discount on food spending and cardiovascular health in remote Aboriginal Australia

        Dr Julie Brimblecombe
        Dr Julie Brimblecombe
        Researcher: Dr Julie Brimblecombe
        Years Funded: 2014 - 2017

        Poor quality diet is a significant risk factor for cardiovascular disease (CVD), cancer and type 2 diabetes – three of the major causes of premature death in the Indigenous Australian population. Much of the burden of disease for Indigenous Australians is due to extremely poor nutrition. However, there is promising evidence that the application of price discounts to encourage healthier food choices at point-of-sale could reduce CVD risk.

        Dr Julie Brimblecombe will investigate the impact and cost benefit of a 20% price discount on fruit and vegetables, water and diet drinks (with and without nutrition education), on targeted foods and cardiovascular health measures. She will also investigate the relationship between indicators of dietary quality and community level measures of cardiovascular health in remote Aboriginal Australia.

        Julie will assess the effect of the price discount through a randomised trial with 20 remote Aboriginal communities. Store point-of-sale data will be used to assess the effect on targeted food. The effect of the price discount intervention on cardiovascular health will be assessed using routinely collected health data from the 20 intervention communities and 20 matched control communities. Improvement in cardiovascular health is expected through a half serve per person per day increase in fruit and vegetables, and associated reduction in dietary sugars and salt. This research will contribute much needed evidence on dietary intervention for improved cardiovascular outcomes.

        Read more
      • Improving diabetes care and management in Torres Strait remote primary health care settings

        Mr Sean Taylor
        Mr Sean Taylor
        Researcher: Mr Sean Taylor
        Years Funded: 2014 - 2016

        The life expectancy gap for Indigenous Australians is 13–17 years, mostly due to preventable chronic disease, including diabetes, heart, lung and renal problems, in adults. However once people have these conditions, many complications can be prevented with good primary-level chronic care.

        Mr Sean Taylor will help to inform the development and implementation of appropriate diabetes, renal and cardiovascular disease (CVD) clinical management care plans to reduce the complications associated with type 2 diabetes, and avoid hospitalisations for CVD and renal disease.

        Sean will undertake two studies. He will aim to understand the attitudes of diabetic Torres Strait Islander adults who have poor glucose and metabolic control, but who resist insulin treatment. Specifically he will look at why they refuse treatment. Mr Taylor will also explore the impact of formal diabetes care planning and referrals on guideline-consistent management (compared to ‘usual care’), clinical care processes and outcomes in remote Torres Strait Islands.

        This research will improve systems of primary healthcare management of CVD and diabetes in these remote high risk populations, and also improve medication adherence (including insulin management) in this group.

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      • Improving early recognition and response to symptoms in acute cardiovascular events

        Dr Janet Bray
        Dr Janet Bray
        Researcher: Dr Janet Bray
        Years Funded: 2014 - 2017

        In acute cardiovascular events such heart attack and stroke cell death begins immediately, and if treatment is not provided in a timely manner permanent damage and even death can occur. However, it is well documented that many people experiencing acute cardiovascular events fail to recognise the serious nature of their symptoms and delay in presenting to hospital.

        Campaigns by the Heart Foundation and the National Stroke Foundation have been developed to improve symptom awareness and the need for rapid action. International evidence suggests these campaigns can improve symptom awareness, but don’t always change behaviour. Recent recommendations suggest targeting individuals at high-risk with tailored education using a theoretical and evidence-based approach.

        Dr Janet Bray’s research will evaluate the impact and content of current Australian campaigns and conduct a pilot study of tailored education based on Illness Behaviour Theory in high-risk groups. It is expected that the outcomes of these projects will inform the future development of campaigns and interventions to improve symptom recognition and reduce delays in presenting to hospital for acute cardiovascular events.

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      • Improving outcomes for Australians with chronic cardiovascular disease: focusing on peripheral arterial disease

        Dr Sally Inglis
        Dr Sally Inglis
        Researcher: Dr Sally Inglis
        Years Funded: 2013 - 2017

        Peripheral arterial disease (PAD) occurs when plaque builds up and narrows arteries.

        It impairs physical function, reduces the patients quality of life and significantly increases their risk of death. Importantly, PAD is responsible for high levels of hospital service usage, accounting for the high rates of heart attack and stroke in people with PAD.

        Tailored and targeted disease management programs are critical to improve the cardiovascular health of Australians. Dr Sally Inglis will examine the characteristics, impact and evidence-based management of PAD, focusing on the population of NSW.

        Findings from this research will have implications for health service provision in NSW and will feed into a greater understanding of the disease nationwide.

        It will also contribute to the provision of up-to-date evidence regarding the effectiveness of interventions to improve self-management by people with PAD, and telemonitoring in chronic heart failure research that will inform clinical guidelines.

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      • Improving outcomes for people with cardiovascular disease in the NSW community

        Professor Adrian Bauman
        Professor Adrian Bauman
        Researcher: Professor Adrian Bauman
        Years Funded: 2014 - 2016

        Professor Adrian Bauman will use this grant to provide new information in several areas relevant to CVD prevention in the community.

        Firstly, he and his research team will identify, in a large sample of middle aged-to-older adults in NSW, the risk factors for heart disease. They will examine new potential risk factors such as prolonged sitting time, sleep time, and also whether multiple risk factors bring greater risk of cardiovascular events or death.

        The second objective is to identify a large sample of people from a population cohort who develop heart disease, and explore their risk factors for developing CVD including smoking, alcohol, physical inactivity, diet, obesity, sitting time and sleep time, as well as the potential contribution of geographic and environmental factors, and social supports.

        Thirdly, they will contact those who have developed CVD, and who have an understanding of the type, severity and management of their disease, to offer a risk reduction lifestyle program to those who need it.

        This program will test new approaches to CVD secondary prevention in the community. This set of projects will combine to form a program of work, from epidemiological studies through to community interventions, to meet the needs of people with CVD.

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      • Improving outcomes in pulmonary hypertension and heart failure

        Dr Aidan Burrell
        Dr Aidan Burrell
        Researcher: Dr Aidan Burrell
        Years Funded: 2014 - 2018

        Overall heart function is determined by the integrated performance of the left and right ventricles. In a variety of common cardiovascular problems (including heart failure, pulmonary hypertension and critical illness in intensive care) the function of the left and right ventricles becomes impaired.

        Currently much of the focus on diagnosis and treatment in cardiovascular medicine has been focused on the left ventricle. The critical role of the right ventricle in determining outcome is increasingly being recognised but has been restricted by the availability of sensitive and accurate tests to assess right ventricular function.

        For example, our ability to predict when the right ventricle will fail in patients with pulmonary hypertension is extremely poor, which often delays the commencement of potentially life saving but complex therapies. Several studies have suggested that the most accurate way to assess right ventricular function is the simultaneous measurement of both the pressure and volume of the right ventricle.

        Dr Aidan Burrell aims to develop an accurate, widely available method for the assessment of right ventricular function, in order to improve outcomes in patients at risk of right heart failure, using novel 3D echocardiographic techniques to enhance available assessment tools.

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      • Improving risk stratification and targeted treatment of patients with heart attack

        Professor Gemma Figtree
        Professor Gemma Figtree
        Researcher: Professor Gemma Figtree
        Years Funded: 2015

        Ischaemic heart disease, which results from disease of the heart’s arteries and impaired blood flow to heart cells, is the leading cause of death in adults. Associate Professor Gemma Figtree’s research program aims to improve the survival and quality of life for patients who experience heart attack, and encompasses three interrelated themes.

        Firstly, building on previous discoveries from her laboratory, Gemma will test the ability of small, lipid-soluble proteins to protect important enzymes in the heart cell’s membrane from oxidative stress. This novel treatment is ready to progress to pre-clinical studies.

        Gemma will then examine its prognostic ability in terms of heart attack, using a biomarker that reflects neurohormonal abnormalities and oxidative stress, and closely parallels these abnormalities in the heart. This biomarker could become a valuable guide for clinicians in determining a patient’s risk and their appropriate treatment strategy.

        Thirdly, using cardiac magnetic resonance imaging (MRI) to assess heart muscle damage resulting from heart attack will allow improved risk determination and identification of complications.

        This integrated program of research will improve the identification of patients at greatest risk of experiencing adverse outcomes after a heart attack, who may benefit from targeted intensive monitoring and therapy.

        Read more
      • Improving the detection of disadvantaged Australians at high risk of cardiovascular disease

        Dr Kathryn Backholer
        Dr Kathryn Backholer
        Researcher: Dr Kathryn Backholer
        Years Funded: 2013 - 2016

        In Australia, heart disease and stroke follow a social pattern, such that individuals living with greater disadvantage are more likely to experience a heart attack or stroke than more socially advantaged people.

        Risk prediction tools are commonly used to identify individuals at high risk of heart disease and stroke and who may benefit from preventive treatment. However, current risk tools in Australia do not take into account the independent risk associated with a lower socioeconomic status, resulting in reduced prioritisation of preventive treatment among individuals who need it most, and potentially exacerbating health inequalities.

        Dr Kathryn Backholer’s research seeks to develop and validate an Australian risk prediction tool to identify individuals at high risk of developing heart disease and stroke that includes a measure of social deprivation. The potential impact on the rate of heart disease and stroke as a result of introducing this new risk prediction tool into clinical guidelines will be examined, as will the tool’s effect on the social inequalities of these diseases in Australia.

        This project has the potential to improve both the effectiveness and allocation of treatments for the prevention of heart disease and stroke, particularly among more disadvantaged Australians.

        Read more
      • Improving the identification and management of depression in people with cardiovascular disease

        Associate Professor Maree Hackett
        Associate Professor Maree Hackett
        Researcher: Associate Professor Maree Hackett
        Years Funded: 2014 - 2017

        Associate Professor Maree Hackett’s research is directed at exploring ways of managing depression in people with cardiovascular disease (CVD).

        Firstly, she will trial interventions aimed at preventing depression and reducing disability in people with heart disease and stroke. These include randomised placebo-controlled trials of six months of a common antidepressant medication (fluoxetine) to prevent depression and improve functional outcome after stroke in Australia, the UK and Sweden. Combining the results of these trials will determine whether fluoxetine prevents depression, reduces disability and increases independence after stroke.

        Secondly, Maree and her team will determine whether a free-to-use screening tool for depression, previously adapted for use with Aboriginal and Torres Strait Islander men, is suitable for routine use with Aboriginal and Torres Strait Islander men and women with a high CVD risk attending primary care services. She will determine if, and how, the screening tool should be used during routine annual adult health assessments within primary care.

        Thirdly, she will maintain and update existing, as well as undertake new, systematic literature reviews and meta-analyses of the literature on the management of depression in people with CVD. These reviews will provide the highest level of research on which to base recommendations for healthcare and clinical practice.

        Read more
      • International strategies to reduce population salt intake

        Dr Jacqui Webster
        Dr Jacqui Webster
        Researcher: Dr Jacqui Webster
        Years Funded: 2015 - 2018

        The World Health Organization (WHO) has recently introduced a new target whereby it is recommended that countries reduce salt intake by 30% by 2025. As such, effective, sustainable and scalable strategies to reduce salt intake are required.

        This research program will support the optimal development of such strategies. It will include trials and intervention research projects, supplemented through a series of systematic reviews and feasibility and cost-effectiveness assessments.

        The main outcome will be new evidence on the effectiveness of different salt reduction interventions. This will be disseminated widely through training and best practice guidelines, and used to guide policy and practice for member countries.

        Read more
      • Interventional immunology in diseases of premature babies

        Dr Claudia Nold
        Dr Claudia Nold
        Researcher: Dr Claudia Nold
        Years Funded: 2015 - 2018

        Prematurity is the leading cause of infant death, with survival as low as 30% in those born before 28 weeks.

        This study aims to better understand causes of death and disability in premature babies, such as the devastating heart and lung conditions known as bronchopulmonary dysplasia and pulmonary hypertension. In this way it is hoped that this study will help improve medical care for our tiniest patients to offer them and their families new hope.

        Read more
      • Investigation and prevention of arterial thrombosis using nanoparticle drug delivery

        Dr Erik Westein
        Dr Erik Westein
        Researcher: Dr Erik Westein
        Years Funded: 2015

        Cardiovascular disease kills one Australian every 12 minutes. The majority of these cases involve heart attack and stroke, which are caused by dislodged blood clots.

        Current treatment typically involves blood thinning therapy to inhibit platelets (the blood cells responsible for blood clots). Although this therapy has proven beneficial, patients often experience substantial bleeding complications because it doesnt act exclusively at sites of clot formation.

        Anti-platelet therapy that specifically interferes with clot formation, yet leaves other areas of the vasculature unaffected, remains a long sought after goal. Dr Erik Westein seeks to achieve this by using drug-loaded nanoparticles that deliver high levels of anti-platelet medicines specifically to the sites of blood clots.

        The nanoparticles are made from natural fat bubbles, one five thousandth of a millimetre in size, that release their drug contents only when they encounter a large blood clot. This happens because at sites of large blood clots, high blood flow will cause the nanoparticles to burst and release their drug contents. Erik and his research team have developed artificial microvessels (vessels on a chip), that he will use to test the potential of the nanoparticles.

        This project is an essential step towards clinical application of nanoparticle based treatment and it will form the basis of a safer and more potent therapy to treat and prevent cardiovascular events.

        Read more
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      • A large-scale randomised trial to define the optimal front-of-pack labelling system for Australian foods

        Professor Bruce Neal
        Professor Bruce Neal
        Researcher: Professor Bruce Neal
        Years Funded: 2013 - 2016

        Professor Bruce Neal will conduct a large-scale randomised trial based on his Foodswitch smartphone application (app). A modification of this app will enable quick, easy and low-cost delivery of different forms of nutrition labelling to large numbers of consumers at the point of sale.

        Bruce aims to provide robust new insight into the potential for different types of front-of-pack nutrition labels to support consumers in their efforts to make healthier food choices. This will also inform the ongoing policy debate about the format of front-of-pack nutrition labelling.

        This research will examine the comparative effects of three different forms of front-of-pack nutrition labelling on the healthiness of foods purchased: colour-coded multiple traffic-light labels (the current public health gold standard); monochrome daily intake guide labels (the current food industry option); the front-of-pack nutrition label format to be selected by the Federal Government.

        Bruce will compare the front-of-pack nutrition label format selected by the Federal Government against each alternative format and against a control group with no additional label information. Firstly, he will evaluate the average healthiness of purchased food products defined by the mean Food Standards Australia and New Zealand (FSANZ) nutrient profiling score. Secondly, he will assess the total fat, saturated fat, sugar, salt and energy concentrations of food purchases.

        This study will, for the first time ever, define the effects of different types of front-of-pack nutrition labels on food purchases, which has health implications for most Australians.

        Read more
      • Lipid disorders in people at high risk of cardiovascular disease

        Dr Esther Ooi
        Dr Esther Ooi
        Researcher: Dr Esther Ooi
        Years Funded: 2015 - 2018

        Emerging evidence suggests that people with high blood levels of a molecule known as lipoprotein(a) – or Lp(a) – have a 60% higher risk of dying from a heart attack. 

        Lp(a) is a low density lipoprotein (LDL), or bad cholesterol-like molecule found in the blood. Why Lp(a) levels are high, how Lp(a) may be lowered, and the prevalence of high Lp(a) in Australian communities have not been established. 

        This project will study how Lp(a) is processed by the liver and the body. It will explore how new medical treatments lower Lp(a) levels; and lastly it aims to identify the prevalence of high Lp(a) in people with premature heart disease. 

        This research will offer new information about the formation and breakdown of Lp(a). It will be useful to doctors looking to find ways to treat high Lp(a) disorders. It may also inform the development of new therapies that in the future may be used to treat people and their families with high Lp(a).

        Read more
      • Living with acute coronary syndrome: what happens to people in the year after a serious heart event in NSW

        Associate Professor Julie Redfern
        Associate Professor Julie Redfern
        Researcher: Associate Professor Julie Redfern
        Years Funded: 2014 - 2017

        Associate Professor Julie Redferns project provides an unprecedented opportunity to determine the experience (including service use), outcomes and costs for NSW patients in the 12 months following admission to hospital with acute coronary syndrome (ACS). A major advantage of the project is the extensive collaboration between NSW Cardiovascular Research Network member organisations and the teams ability to use existing infrastructure from the recent Snapshot ACS study a national audit of ACS patients, of whom 1,017 were from NSW. Snapshot ACS was funded through contributions from state and territory clinical networks, the Heart Foundation and the Cardiac Society of Australia and New Zealand. Julie will follow up on the NSW cohort of Snapshot ACS and undertake research to define the economic argument for re-engineering secondary prevention (methods of disease detection and the development of symptoms), which will inform the design of services that are more relevant to patients needs. Through this project, Julie will determine patient outcomes at 12 months post-hospitalisation, including incidence of death, rehospitalisation, quality of life, financial burden, proportion of patients adhering to recommended medicines, and proportion with cardiovascular risk factors. She will also explore the patient and hospital factors associated with better outcomes.

        Read more
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      • Making active choices more attractive: do physical activity incentives improve heart health?

        Professor Kylie Ball
        Professor Kylie Ball
        Researcher: Professor Kylie Ball
        Years Funded: 2015 - 2016

        Would more people be encouraged to become physically active and sit less if offered tangible incentives for doing so? How cost-effective is this approach? These are the novel questions that the proposed study will address.

        In the context of epidemic rates of sedentary lifestyles and obesity, there is increasing interest from a range of stakeholders in using incentives to motivate changes in health behaviours related to obesity.

        This study will trial an innovative incentive-based approach to promoting physical activity and reducing sedentary behaviours among adults. It will also test the impact of these approaches on behaviours, body weight and blood pressure.

        Read more
      • Management of families following a sudden cardiac death caused by a genetic heart disease

        Dr Jodie Ingles
        Dr Jodie Ingles
        Researcher: Dr Jodie Ingles
        Years Funded: 2012 - 2015

        The sudden cardiac death (SCD) of a family member is the tragic result of many genetic heart diseases, and raises confronting issues at a time of stress.

        Dr Jodie Ingles’ research aims to describe the psychosocial wellbeing of this group of people, and find out whether an individual’s choice to follow – or not follow – advice about clinical screening for the disease affects his or her future health.

        Jodie will describe current family management practices, highlighting circumstances in which families fail to receive best-practice care based on established guidelines. She will also carry out a health economic analysis to determine the most cost-effective family management strategy.

        Such an analysis is crucial to determine whether or not any given strategy should be offered to all families, and will guide future policy and resource allocation. The ultimate goal is that every family who experiences an SCD is offered high quality, cost-effective management practices that will lead to the best possible outcome for all family members.

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      • The Melbourne depression in heart failure collaborative - medication trial

        Professor David Hare
        Professor David Hare
        Researcher: Professor David Hare
        Years Funded: 2009 - 2016

        In patients with chronic heart failure (CHF), depression is common, more severe, and doesnt improve as easily as it can in other groups of patients with poor heart health. Unfortunately at the present time, depression is rarely even screened for, let alone treated in patients with CHF.

        Many patients have a milder form of depression that is debilitating, yet not considered a depressive illness, and often not treated. For people who experience minor depression, the experience and consequences are often anything but 'minor'.

        Data demonstrate that depression is a major marker of declining future health, including death, in CHF patients. However no studies have demonstrated that the depression in these patients can be improved, let alone whether an improvement in depression might improve the clinical status of the heart failure patient.

        David's randomised controlled trial will test the concept that both minor and major depression can be improved in CHF patients by using antidepressant medication. The study will also examine whether, by reducing depression, other known medical risk factors (related to both depression and CHF) can be improved.

        The outcomes of this study may increase our understanding of the link between depression and poor heart health, and may indicate whether treating depression can indeed reduce hospitalisation and death due to cardiac complications.

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      • Molecular characterisation of cellular changes in thoracic aortic aneurysm

        Dr Alex Huang
        Dr Alex Huang
        Researcher: Dr Alex Huang
        Years Funded: 2013 - 2016

        Aortic aneurysm occurs when the aorta, the largest blood vessel in the body, expands to more than 1.5 times the normal diameter. This expansion may result in a weakness of the aorta and ultimately in rupture, internal bleeding and death.

        Aortic aneurysm is the 13th leading cause of death in Western countries. Aortic aneurysm usually develops in the sixth or seventh decade of life, appears to be associated with the ageing process, and the cause is unknown.

        Previous research has identified that a protein found in cells lining the aorta, known as SENEX, dampens inflammation in blood vessels and may help to prevent aortic aneurysm.

        Dr Alex Huangs project will increase our understanding of the role of SENEX in the development of aortic aneurysm. This may ultimately lead to the development of novel therapeutic strategies that may prevent and even reverse aortic aneurism.

        Read more
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      • New genetic approaches to inherited heart disease

        Dr Belinda Gray
        Dr Belinda Gray
        Researcher: Dr Belinda Gray
        Years Funded: 2015

        Dr Belinda Gray will perform a comprehensive clinical and genetic investigation of individuals and families with genetic heart diseases, focusing on families where a genetic cause has not yet been identified, using newer genetic approaches such as cardiac gene chips and next generation sequencing strategies (e.g. whole exome sequencing).

        Belinda's research will cover a range of inherited heart diseases, including those affecting the heart structure (e.g. cardiomyopathies) and those affecting the heart's electrical (rhythm) system.

        There are multiple potential reasons why commercial genetic testing fails to find a causative genetic mutation in up to 50% of all genetic heart disease. These include genes not having been previously investigated in genetic heart disease, gene faults that are overlooked by commercial genetic testing, and diseases that mimic inherited heart disease but are actually something entirely different.

        Belinda will identify novel genetic causes for inherited heart disease, and evaluate the utility and impact of the newer mass genetic testing approaches. Ultimately, this research will improve the care of families with inherited heart disease through more accurate diagnosis and the initiation of early prevention strategies.

        Read more
      • New imaging techniques and targeted therapies for heart attack and stroke

        Professor Christoph Hagemeyer
        Professor Christoph Hagemeyer
        Researcher: Professor Christoph Hagemeyer
        Years Funded: 2012 - 2016

        Cardiovascular disease (CVD) is usually caused by a gradual clogging of the arteries that supply blood to the heart, brain and other vital organs. In this process, called atherosclerosis, fatty material known as plaque slowly builds up on the inner walls of these arteries, causing them to become narrow.

        If an area of plaque ruptures, blood cells and other parts of the blood stick to the damaged area and may completely block blood flow through the artery. This can lead to a heart attack or stroke major causes of death and disability both in Australia and worldwide.

        Professor Christoph Hagemeyers research aims to develop new ways to prevent, diagnose and treat heart attack and stroke. First, he will investigate whether its possible to tell which areas of plaque are unstable and likely to rupture in the future. He will also use ultrasound to quickly locate blood clots once they have formed, to direct prompt treatment. Thirdly, Christoph will use nanotechnology to deliver clot-busting medicines to the site of the clot.

        This method means that treatment can be given as soon as a heart attack or stroke is diagnosed, without the need for specialised equipment, which may not be available outside major hospitals.

        For the many Australians living in regional, rural and remote areas, this means that heart attacks and strokes may be treated much more quickly, and the deaths and health burden caused by CVD may be significantly reduced.

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      • A new type of exercise to improve the health of patients with heart failure

        Professor Daniel Green
        Professor Daniel Green
        Researcher: Professor Daniel Green
        Years Funded: 2015 - 2016

        Heart failure is common, affecting 10% of those aged over 65 years. Although impaired heart function initiates the syndrome, changes in the skeletal muscle and blood vessels impair function and quality of life.

        Exercise training is particularly relevant in heart failure because fitness predicts disease outcome and guides timing and prioritisation for transplantation. Exercise training is recommended in clinical guidelines, but distinct adaptations to exercise are conferred by different types of training.

        We will study a novel training approach which has several theoretical advantages over traditional approaches. Our aim is to compare the effects of this new form of exercise to those of conventional training in a superiority trial.

        The findings of this study will help to optimise exercise prescription in heart failure and directly benefit patients in terms of life expectancy and quality.

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      • N-of-1 trials for patients with myalgia while taking statins

        Dr Nicole Li
        Dr Nicole Li
        Researcher: Dr Nicole Li
        Years Funded: 2015

        This study aims to establish the feasibility of using trials involving only one patient (N-of-1) to improve the diagnosis of statin-induced myalgia (muscle pain) in the Australian general practice setting. Muscle-related symptoms are the most commonly reported reason for statin discontinuation and about 1 in 5 patients taking statins report some degree of muscular pain.

        Placebo-controlled trials indicate that overall in a treated population most symptoms are not due to the statin. However, for an individual patient it is typically impossible to be certain. N-of-1 (single-patient multiple crossover) trials offer a simple, intuitive way to resolve this uncertainty.

        The study will include up to 15 N-of-1 trials conducted in three general practices in the Sydney region. Patients with prior statin-related myalgia occurring within three weeks of starting statin therapy, and who discontinued statin use, will be invited to participate. Each person will go through three double-blind, crossover comparisons of statin versus matching placebo, each separated by a three week break. 

        The primary outcome will be the visual analogue scale (VAS) myalgia score ranging from 0 mm to 100 mm. Data from each N-of-1 trial will be analysed individually and then combined using the empirical Bayesian model.

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      • Nurse-led tailored risk reduction in atrial fibrillation

        Dr Alicia (Lis) Neubeck
        Dr Alicia (Lis) Neubeck
        Researcher: Dr Alicia (Lis) Neubeck
        Years Funded: 2015

        Atrial fibrillation is the most common cardiac arrhythmia (irregular heart beat), and causes stroke, reduces quality of life and can lead to premature death. Although atrial fibrillation is manageable, and the complications are preventable through medication and lifestyle support, few people are included in risk factor reduction programs.

        There is increasing evidence that comprehensive risk factor reduction programs can improve quality of life, reduce symptoms, increase medication adherence and decrease stroke, hospitalisation and death.

        Our study uses an innovative approach to determine whether a nurse-led atrial fibrillation clinic, facilitated by a tailored electronic decision support (EDS), can improve multiple cardiovascular risk factors.

        The EDS will assist with implementation of guideline-based practice, while skilled cardiac nurses will deliver tailored behaviour change strategies to improve quality of life, increase physical activity and facilitate adherence to medication.

        Read more
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      • On the TRAIL of obesity, diabetes and cardiovascular disease

        Dr Mary Kavurma
        Dr Mary Kavurma
        Researcher: Dr Mary Kavurma
        Years Funded: 2013 - 2016

        In humans, obesity, diabetes and cardiovascular disease (CVD) are inexorably linked, with obesity greatly increasing the risk of type 2 diabetes and some CVDs. However, the precise cause of disease is unclear.

        A protein known as TRAIL (tumour necrosis factor-related apoptosis-inducing ligand) was originally identified as an inducer of cancer cell death. Dr Mary Kavurmas CVD studies indicate that TRAIL may also have an important new function in facilitating the survival of cells, as distinct from its function in cell death.

        Using laboratory models, her research group have recently shown that, in response to a Western diet, TRAIL deficiency may be linked to obesity, diabetes and significant artery blockage. However, it is unclear why TRAIL deficiency leads to obesity, diabetes and CVD. The critical next step is to define the mechanistic pathway(s) and tissue specific effects for the protective role of TRAIL observed in laboratory models. Mary will also assess the therapeutic potential of TRAIL in these disease settings.

        This study will not only provide new discoveries, but may help develop more effective treatments for the debilitating conditions associated with obesity, diabetes and CVD.

        Read more
      • Outcomes of surgery for rare heart defects in children

        Dr Edward Buratto
        Dr Edward Buratto
        Researcher: Dr Edward Buratto
        Years Funded: 2014 - 2019

        Birth defects affecting the heart occur in one in every 100 children, making them the most common type of birth defect. Partial atrioventricular septal defect (pAVSD) is one of the most common types of childhood heart defects, and is treated with surgery in the pre-school years. Survival in the short- and long-term is known to be excellent, however these children very often need repeated surgeries and it’s difficult to predict which children will be affected. Furthermore, the long-term quality of life and functional outcomes such as rate of school completion and employment are not well understood.

        Dr Edward Buratto will provide up to date information on outcomes for these patients when treated in Australian and New Zealand hospitals, in terms of survival, repeat surgeries, complications and quality of life. He will also seek to identify risk factors for having poorer outcomes in order to determine prognosis more accurately. This is important not only for providing accurate information to parents and patients as they grow up, but also to allow us to identify which surgical practices give the best rates of survival and fewest complications.

        This research will lead to more focused follow-up and treatment for patients at the greatest risk of complications to ensure the best outcomes. It will also allow for optimal allocation of precious health resources.

        Read more
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      • Performance and delivery of cardiovascular heath services

        Dr Isuru Ranasinghe
        Dr Isuru Ranasinghe
        Researcher: Dr Isuru Ranasinghe
        Years Funded: 2013 - 2016

        Cardiovascular disease (CVD) is a well known cause of death and disability within the Australian population. Specifically, hospitalisation for acute myocardial infarction (AMI), heart failure (HF), coronary revascularisation (restoring blood flow to the heart) and cardiac device implantation are all common and costly.

        Improving patient care in the hospital sector has been recognised as a national priority in proposed national health reforms, and better methods to evaluate care are a fundamental component of achieving this goal. However, methods of systematically collecting and reporting on cardiovascular quality indicators in Australian hospitals are lacking.

        With this Overseas Fellowship, Dr Isuru Ranasinghe will attend the Centre for Outcomes Research and Evaluation (CORE) at Yale University in the USA under the supervision of Professor Harlan Krumholz. CORE is an internationally renowned centre for evaluation of quality of care in CVD.

        In collaboration with CORE, Isuru will seek to develop novel methods and capacity enhancers for improved systematic evaluation of quality of care in Australian hospitals. This is a pivotal requirement to ensure high quality care is delivered to patients in an efficient and cost-effective way.

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      • Physical activity and cardiovascular risk in people following chronic stroke

        Ms Natalie Fini
        Ms Natalie Fini
        Researcher: Ms Natalie Fini
        Years Funded: 2013 - 2016

        Stroke is a major cause of disability in Australia, affecting over 50,000 people annually. Stroke survivors are at increased risk of serious ongoing health problems, particularly a second stroke. However many of the risk factors for a second stroke, such as smoking, poor diet and lack of physical activity, can be reduced through greater awareness, targeted therapy, education and support.

        Ms Natalie Fini will conduct a longitudinal study to investigate physical activity levels and cardiovascular risk factors in the two years following discharge from therapy after the patient’s first stroke. This study will identify relationships between physical activity, cardiovascular risk, physical function and fatigue. If a link between physical activity and cardiovascular risk is demonstrated, a strong rationale will be provided for therapies that improve physical activity participation in people who have had a stroke.

        This project will also identify the unique barriers to participation in physical activity faced by people who have had a stroke, and ways to overcome these barriers. This will allow for the development and testing of targeted therapies to improve participation in physical activity for this high risk population.

        Read more
      • Physical activity and eating behaviours over key transitions from early childhood to young adulthood

        Associate Professor Anna Timperio
        Associate Professor Anna Timperio
        Researcher: Associate Professor Anna Timperio
        Years Funded: 2014 - 2017

        Physical activity and healthy eating are the cornerstones of good cardiovascular health and it is critical to establish these behaviours early in life. The transitions into primary school, secondary school and out of secondary school are considered critical times when changing circumstances can cause detrimental changes to physical activity and eating. However, few studies have focused on these critical periods.

        With this Future Leader Fellowship, Associate Professor Anna Timperio aims to understand how and why physical activity and eating behaviours change during these critical periods of transition.

        Anna will examine how physical activity and eating behaviour changes, and the influence of families and neighbourhoods on these changes. She will also look at the complexities of how families and neighbourhoods influence physical activity and eating behaviour changes using new methods of conceptualising neighbourhood environments.

        This research will inform intervention efforts to help children and adolescents maintain a healthy lifestyle, and promote resilience in the face of detrimental lifestyle changes during these high risk periods. It will also generate information about how we can create neighbourhoods that support physical activity and healthy eating for all age groups.

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      • The PINBALL pilot randomised controlled trial

        Dr Edward Litton
        Dr Edward Litton
        Researcher: Dr Edward Litton
        Years Funded: 2014 - 2016

        Intra-aortic balloon counterpulsation is a method of temporary mechanical circulatory support that helps to regulate the heart’s oxygen supply and demand.

        Dr Edward Litton’s project is the next phase in a program of research that aims to determine whether, in high-risk patients undergoing cardiac surgery, intra-aortic balloon counterpulsation reduces the risk of major complications including death, heart attack and kidney failure when commenced prior to surgery.

        Approximately 15,000 patients in Australia, and over 800,000 worldwide, undergo coronary artery bypass surgery each year for severe blocked arteries in the heart. While the overall risk of complications from cardiac surgery is low there is a subset of patients at a much higher risk of major complications.

        Edward’s previous research demonstrated that high risk patients, who may benefit from preoperative intra-aortic balloon counterpulsation, can be identified prior to surgery, however such intervention is currently uncommon in Australia. The PINBALL pilot study will test its feasibility. It will provide the basis for conducting a definitive trial to determine whether preoperative intra-aortic balloon counterpulsation can reduce mortality and major complications in high risk patients undergoing cardiac surgery.

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      • Population based dynamic modelling

        Dr Yohannes Kinfu
        Dr Yohannes Kinfu
        Researcher: Dr Yohannes Kinfu
        Years Funded: 2012 - 2015

        The healthcare environment in Australia, and elsewhere in the developed world, is evolving rapidly due to developments in medical technology, population ageing and the increasing dominance of lifestyle diseases and chronic conditions requiring long-term care.

        Dr Yohannes Kinfu will use dynamic population-based modelling in Australia to model the effects of salt reduction, the economic burden of ill health due to physical inactivity, and the prevalence of risk factors for cardiovascular disease (CVD). Data from 1911 to 2011 will be used to model trends in age and gender-specific mortality rates due to CVD and provide forecasts to 2031.

        Dr Kinfu will analyse the effect of various lifestyle factors – including salt reduction, physical activity, smoking, and fruit and vegetable consumption – on the probability of developing CVD. The same work will also shed light on co-morbidity between CVD and type 2 diabetes, and the dynamic factors that are at play.

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      • Preventing weight gain in women: a translation project

        Dr Cheryce Harrison
        Dr Cheryce Harrison
        Researcher: Dr Cheryce Harrison
        Years Funded: 2014 - 2016

        Healthy lifestyles, and the prevention of weight gain and obesity, are public health priorities highlighted in key government policies and the Heart Foundation’s 2013–2017 Research ‘Healthy Hearts’ Strategy. Excess weight is irrefutably linked to metabolic syndrome, type 2 diabetes and cardiovascular disease (CVD). Healthy lifestyle intervention can reduce risk, representing a significant public health initiative.

        Alongside healthy lifestyle, accurate risk perception and risk factor screening are important in CVD prevention. Young and midlife women present a high-risk group and should be targeted, due to their: adverse lifestyles and high rates of weight gain; greater cardiovascular implications of obesity than men; adverse metabolic changes and weight redistribution around menopause; poor perception of CVD risk; and inadequate screening and prevention practices.

        Dr Cheryce Harrison’s fellowship builds on a strong evidence-base of successful health interventions in women. This work includes the establishment of efficient healthy lifestyle intervention that improves healthy lifestyles and prevents weight gain in younger women in a large randomised control trial (Phase 1), and formative research informing the adaptation of the lifestyle program, to develop novel resources and to run a pilot implementation program in women at midlife (Phase 2). Phase 2 will incorporate education on CVD risk perception and risk factor screening, and both will reduce obesity and CVD risk factors.

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      • Promoting active, healthy lifestyles among women at key life-stages

        Dr Verity Cleland
        Dr Verity Cleland
        Researcher: Dr Verity Cleland
        Years Funded: 2015 - 2019

        Physical inactivity is a significant risk factor for cardiovascular disease (CVD). Physical activity, on the other hand, is beneficial in preventing and managing major CVD risk factors such as high blood pressure, high cholesterol, diabetes, obesity and depression. Despite this, 70% of Australian adults are not active at recommended levels.

        Some groups – including women, those experiencing socioeconomic disadvantage and those living in rural areas – are even less active. Changing behaviour is difficult, but key life stages and events (e.g. leaving school, parenthood and retirement) are times when changes in social roles, peer groups, schedules and leisure activities occur. These may therefore be important times to promote health messages.

        This research will identify the critical factors during life transitions that underlie women's physical activity, and test strategies that target these factors to increase physical activity levels. Increases in physical activity will lead to improvements in cardiovascular health in these high-risk population groups.

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      • Providing children with a heart healthy start to life

        Dr Kylie Hesketh
        Dr Kylie Hesketh
        Researcher: Dr Kylie Hesketh
        Years Funded: 2014 - 2017

        Dr Kylie Hesketh’s research is aimed at examining correlations and predictors of physical activity and sedentary behaviours from early childhood, and developing and investigating the effectiveness of strategies to promote physical activity and reduce sedentary behaviours in the early childhood population.

        Maximising physical activity and reducing sedentary behaviours are important for health and wellbeing throughout life. Early childhood (prior to the commencement of school) has been identified as a critical period in the formation of these behaviours, which have established links (directly and indirectly) with cardiovascular health both during the early childhood period and in later life. Yet many young children fail to meet national guidelines for recommended levels of physical activity, and exceed recommended levels of television viewing (one form of sedentary behaviour).

        Kylie will conduct longitudinal cohort and family-based randomised controlled trial studies focused on the early childhood population. This information will provide greater understanding of the factors that influence physical activity and sedentary behaviours, and of mechanisms of behaviour change from a young age. This research includes the development and understanding of early life interventions. It has the potential to increase physical activity and decrease levels of sedentary behaviour, thereby providing young children with a heart healthy start to life.

        Read more
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      • Rapid differentiation of stroke in the emergency setting

        Dr Phuong Ghi
        Dr Phuong Ghi
        Researcher: Dr Phuong Ghi
        Years Funded: 2014 - 2016

        Stroke is the second most common cause of death and the leading cause of disability in Australia. Analyses of data from multiple randomised trials support the position that thrombolytic therapy to dissolve a clot, using recombinant tissue plasminogen activator given up to three hours after the onset of symptoms of acute ischaemic stroke, increases functional outcome (i.e. independence at final follow-up) without affecting mortality.

        Definitive confirmation of a patient’s suitability for thrombolytic therapy (such as the presence of acute ischaemia and the absence of haemorrhage, necrosis and stroke mimics) requires access to a magnetic resonance imaging (MRI) scanner. Unfortunately, this is not always feasible given the three-hour window, especially in rural and remote areas and busy urban medical centres.

        Dr Phuong Ghi will assess the viability of introducing a portable imaging device – magnetoacoustic tomography by magnetic induction (MAT-MI) – to the emergency setting for rapid diagnosis and risk determination of acute ischaemic stroke. Phuong will also assess the viability of MAT-MI in monitoring ischaemia, haemorrhage and tissue necrosis during recovery. The overall objective is to deliver a treatment protocol that enhances the delivery of safe and effective stroke management practices.

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      • Recalibrating the cardiovascular risk assessment tool pertinent to the Australian population

        Professor Mark Woodward
        Professor Mark Woodward
        Researcher: Professor Mark Woodward
        Years Funded: 2014 - 2015

        Cardiovascular disease is a leading cause of premature death and disability in Australia, affecting the lives of many. It is, thus, essential for doctors to be able to target preventive strategies and treatment to those with the greatest need.

        Current methods for assessing risk in Australia are based on outdated data from the USA and take no account of social deprivation, ethnicity or family history of cardiovascular disease - all known to be important determinants of cardiovascular risk.

        This project will use the largest pool of Australian data currently available to develop, and test, a modern Australian cardiovascular risk score.

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      • Reducing barriers and improving access to cardiovascular care for Aboriginal and Torres Strait Islander men

        Mr Justin (Kootsy) Canuto
        Mr Justin (Kootsy) Canuto
        Researcher: Mr Justin (Kootsy) Canuto
        Years Funded: 2015 - 2016

        The causes of health disadvantage among Aboriginal and Torres Strait Islander men are complex and interwoven. The ill health experienced by Indigenous Australians, particularly men, is demonstrable across virtually all measures of death and disability. Primary healthcare services are critical for health and wellbeing, but remain under-used by Aboriginal and Torres Strait Islander men. 

        This project will evaluate an Indigenous Australian men’s health program that operates in South Australia. A cross sectional survey of psychosocial and cardiovascular risk will be undertaken in men involved in the program. Interviews with a sample of local service providers and participants will be undertaken to understand to what extent the program is meeting both groups needs or can be improved.

        The project will contribute to the noticeable gap in the Indigenous Australian health literature, particularly on strategies aimed at reducing barriers and increasing access to primary healthcare and social services for Aboriginal and Torres Strait Islander men. Ultimately it is hoped this research will contribute to an increased awareness of cardiovascular risk and disease among Australian Aboriginal men.

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      • Reducing cardiovascular disease in women and their children

        Lisa Moran
        Lisa Moran Lisa Moran
        Researcher: Lisa Moran

        Obesity is associated with an increased risk of a number of diseases and health conditions, including type 2 diabetes and cardiovascular disease (CVD). Women in their childbearing years have an increased risk of becoming obese, and there are associations between a mothers obesity, a greater weight gain during pregnancy, and the subsequent health risks for both mother and child.

        Pregnancy and childbirth are key milestones for women and present a unique opportunity for health professionals to provide advice and support to facilitate lifestyle change to improve the health of mothers and their children. Effective interventions during pregnancy that can modify a womans (and her infant's) risk of subsequently developing obesity, CVD and diabetes have enormous potential to curb the burden of disease related to obesity.

        Dr Lisa Moran's research will assess the effect of lifestyle interventions in women during pregnancy on weight management and cardiovascular and diabetes risk post-pregnancy, and on obesity and metabolic risk in infants. As half of Australian women are overweight or obese, Lisa's research has the potential to improve the health and lives of many mothers and their children, giving them a better, healthier start in life.

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      • Reducing cardiovascular disease risk by moving more and improving sleep: the Balance study

        Dr Mitch Duncan
        Dr Mitch Duncan
        Researcher: Dr Mitch Duncan
        Years Funded: 2015

        Many adults are physically inactive, sit for long periods of time and have poor sleep behaviours, increasing their risk of cardiovascular disease.

        This innovative study compares the effectiveness of two technology based interventions to help adults track and improve their physical activity, sedentary and sleep behaviours. One group receives a specifically developed app, with participants manually entering information into the platform to track their behaviour and the changes made. The other group receives an activity tracker, in addition to the app, to automatically measure activity, sedentary and sleep-wake behaviours.

        Taking a 24-hour approach to health, this study helps to understand how technology can be used to improve multiple behaviours linked to cardiovascular disease.

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      • Reprogramming cells to assist new blood vessel growth in cardiovascular disease

        Dr Sanjay Patel
        Dr Sanjay Patel
        Researcher: Dr Sanjay Patel
        Years Funded: 2011 - 2015

        Angiogenesis is the formation and development of new blood vessels. This process plays an essential role in the body by helping to heal wounds or restore blood flow to damaged parts of the body. Many forms of cardiovascular disease (CVD) occur when there is a blockage in a vessel or artery that supplies blood to an area of the heart or brain. This can have disastrous consequences, as cells in the heart and brain need a constant supply of blood to maintain their function and stay alive. Angiogenesis can assist in these conditions through the growth of new blood vessels to bypass the blockage, thereby restoring normal blood supply to the oxygen and nutrient-starved cells. Researchers have identified a rare type of cell in the bloodstream that they believe may assist in angiogenesis and blood vessel repair. These cells are called endothelial progenitor cells. With this Postdoctoral Fellowship, Dr Sanjay Patel hopes to re-program normal cells into specialised endothelial progenitor cells. He will deliver these cells to the site of a blocked blood vessel in a laboratory model to determine if they will begin angiogenesis to bypass the blockage. If successful, this research could mean angiogenesis could be controlled and promoted in particular areas of the body. This would be a breakthrough in the treatment of many forms of CVD and could help prevent many deaths from heart attack or stroke.

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      • Rheumatic heart disease screening

        Dr Daniel Engelman
        Dr Daniel Engelman
        Researcher: Dr Daniel Engelman
        Years Funded: 2014 - 2016

        Research funded by the Heart Foundation has found that children found to have rheumatic heart disease (RHD) on screening can progress to severe disease, and need to be closely monitored to help manage the disease and prolong life.

        Rheumatic heart disease leads to serious complications such as stroke and premature death in adolescents and young adults. While the disease is preventable and treatable when found early, young people continue to die because the disease is detected too late.

        Researcher Dr Daniel Engelman, from the Centre for International Child Health at the University of Melbourne, followed a group of children in Fiji with RHD from 2006 to 2015.

        Dr Engelman and his colleagues from the Fiji Ministry of Health performed repeat ultrasounds to understand how RHD changed over time and conducted interviews with patients and families to better understand the disease, management and the impact on their lives.

        His research found that after the first screening, even children with the mildest form of rheumatic heart disease can develop severe disease and complications, and need to be rechecked at regular intervals with medical staff.

        In another project last year, nurses were trained to perform the heart ultrasounds, which will be needed in areas where there are no doctors.

        Currently, a shortage of echocardiographers and cardiologists to perform and interpret RHD ultrasound tests is a major barrier to detecting the disease early.

        Dr Engelman says this work could lead to a feasible strategy that Australia and other countries could implement to find cases in remote areas before they become too sick and commence the preventative treatment.

        “I am extremely grateful for the ongoing support of the National Heart Foundation, without whom my research in this area wouldn’t have been possible.”

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      • The role of diffuse myocardial fibrosis in myocardial stiffness

        Dr Leah Iles
        Dr Leah Iles
        Researcher: Dr Leah Iles
        Years Funded: 2014 - 2017

        Optimal function of the heart muscle facilitates both normal pumping and relaxation of the heart. The former squeezes blood into the circulation, while the latter allows filling of the heart with blood returning from the body.

        In some individuals the muscle becomes stiffer, causing difficulty with both pumping and relaxing. Heart muscle stiffness is largely determined by the composition of the muscle itself. We know that in conditions with increased collagen, the muscle is stiffer. Collagen is a major component of scar tissue, such as in areas of heart affected by myocardial infarction (heart attack).

        There are other conditions in which the accumulation of collagen is more diffusely distributed through the heart muscle. It may be expected that diffuse fibrosis would result in cardiac stiffness in all types of heart disease. Dr Leah Iles' previous research has shown that markers of stiff heart muscle on ultrasound scan (echocardiogram) correlate with findings of increased collagen on cardiac magnetic resonance imaging (MRI) scan.

        With this fellowship, Leah will establish: a link between the MRI findings and more direct measures of pressure/stiffness in the heart; a correlation between the degree of stiffness and amount of collagen; and whether a medication to reduce fibrosis results in a reduction of cardiac muscle collagen.

        The desired outcome is that these findings will aid diagnosis and prognosis and lead to an effective treatment for heart muscle stiffness.

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      • The role of high-density lipoproteins in inhibiting inflammatory factors that promote stent failure

        Ms Laura Vanags
        Ms Laura Vanags
        Researcher: Ms Laura Vanags
        Years Funded: 2013 - 2015

        Smooth muscle cells (SMC) are found in the walls of arteries and veins, and their primary role is to control the dilation and constriction of the flow of blood to tissues. However, following an inflammatory insult such as stent implantation (insertion of a mesh tube that re-opens vessels blocked by fatty deposits), SMCs start to divide (proliferate), rapidly causing their re-growth over the stent (restenosis). This restricts the flow of blood and triggers early stent failure.

        This process is called intimal hyperplasia and is driven by inflammation and the proliferation of SMCs. High-density lipoproteins (HDL), the ‘good cholesterol’, inhibit inflammation and SMC proliferation.

        Ms Laura Vanags will determine the potential therapeutic role of HDL in intimal hyperplasia and the prevention of early stent failure.

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      • The role of phosphatase enzymes in heart failure

        Dr Kate Weeks
        Dr Kate Weeks
        Researcher: Dr Kate Weeks
        Years Funded: 2013 - 2017

        Heart failure affects 300,000 Australians and accounts for 2% of all deaths. Prognosis is very poor – approximately 45% of women and 60% of men with heart failure die within five years of being diagnosed.

        Despite this, one of the undoubted success stories in the treatment of heart failure has been the development of beta-blockers. These medicines improve heart function and symptoms, and reduce mortality, but are associated with significant side effects. Further research is needed to understand the cellular and molecular mechanisms underlying the clinical benefit of beta blockers.

        Ms Kate Weeks is investigating the role of a protein known as B56α in regulating the function of the healthy and failing heart. Preliminary data suggest that B56α is a critical regulator of heart function and may play a causal role in the development of heart failure. The information generated by this project could lead to the development of new or improved medicines for the treatment of heart failure.

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      • The role of renal glucose handling in the development of diabetic kidney disease

        Dr Linda Gallo
        Dr Linda Gallo
        Researcher: Dr Linda Gallo
        Years Funded: 2013 - 2015

        Diabetes is a major cause of cardiovascular disease, while poor kidney function in diabetes further increases this risk. Anti-diabetic drugs, called sodium dependent glucose transporter-2 (SGLT2) inhibitors, have recently become available for use in type 2 diabetes.

        These agents block a component within the kidney that is responsible for retaining glucose in the bloodstream. This causes glucose to be excreted through the urine and lowers levels in the blood. However, long-term cardiovascular outcomes are unknown.

        This study aims to determine whether lowering blood glucose levels in diabetes, by promoting the kidney to excrete glucose into urine, is protective against kidney disease and cardiovascular diseases. It also aims to determine whether insulin regulates the activity of SGLT2, in addition to another glucose transporter that was recently identified as being upregulated in the diabetic kidney.

        This study will help to refine strategies for treating diabetes that reduce cardiovascular risk.

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      • The role of the brain in essential hypertension

        Mr David Carter
        Mr David Carter
        Researcher: Mr David Carter
        Years Funded: 2012 - 2015

        Hypertension (high blood pressure) is a major contributing risk factor to the development of cardiovascular diseases such as stroke, and is therefore a component of the greatest cause of death and disability in all societies. Essential hypertension, a term used to describe high blood pressure where the cause is unknown, is estimated to account for more than 70% of hypertension cases.

        Increased nervous activity from the brain to the cardiovascular system, known as sympathetic nerve activity, is linked to the genesis and persistence of essential hypertension, which has been associated with increased activity of the Renin-Angiotensin System (RAS), a hormone that regulates blood pressure and water balance.

        Unfortunately, the links between RAS and an increased sympathetic output, and thus increased blood pressure, are poorly defined. Using state-of-the-art approaches to focus on the part of the brain where the RAS is found, Mr David Carter aims to provide unique insights into its relative contribution to sympathetic activity and blood pressure control.

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    16. S

      • Safety and benefits of water-based exercise for people with chronic heart failure

        Ms Julie Adsett
        Ms Julie Adsett
        Researcher: Ms Julie Adsett
        Years Funded: 2012 - 2017

        Exercise is usually recommended for people with chronic heart failure (CHF), as it has been shown to improve symptoms and quality of life. Specialised exercise programs are often conducted in hospital gymnasiums, but for people with muscle and joint pain or balance problems, these traditional programs can prove difficult. While exercising in warm water may be a better option for such patients, concerns about safety for people with heart failure have been raised.

        Miss Julie Adsett will investigate the safety, effectiveness and acceptability of exercising in water to improve fitness, strength and balance in a group of patients with stable CHF. Her research will include a comparison of a gymnasium exercise program with one performed in the hospital hydrotherapy pool. In particular, the study will compare how the body regulates blood pressure, blood flow and body temperature in both of the exercise settings. Additionally, participants views about the positive and negative aspects of exercising in water will be recorded.

        If Julie's research shows that exercise in a heated pool is safe and results in the same improvements as exercise in a gymnasium, a wider range of evidence-based programs may be offered to people with CHF, enabling them to exercise in a way that suits their individual needs. With hundreds of thousands of Australians estimated to be affected by heart failure, these findings have the potential to improve quality of life for many.

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      • The safety of pharmacotherapies for smoking cessation

        Dr Alys Havard
        Dr Alys Havard
        Researcher: Dr Alys Havard
        Years Funded: 2015 - 2019

        Smoking is a major risk factor for cardiovascular disease. Programs that support smokers to quit therefore have the potential to improve cardiovascular health.

        Pharmaceutical products, including bupropion, varenicline and nicotine replacement therapy, are the most effective strategies available to help people quit smoking. However, there have been highly publicised concerns regarding the safety of these medications. In particular, the potential increased risk of cardiovascular events, depression, suicide and seizures among people who take them. These concerns are likely to deter smokers from using these quit aids.

        This project will measure the safety of smoking cessation medications by linking pharmaceutical prescription records with records of other health service use. It will provide robust evidence that will allow smokers and their physicians to make informed decisions about using these medications.

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      • Secondary prevention: increasing uptake and engagement to reduce cardiovascular events

        Associate Professor Julie Redfern
        Associate Professor Julie Redfern
        Researcher: Associate Professor Julie Redfern
        Years Funded: 2014 - 2017

        Cardiovascular disease is a common, long-term health problem. Despite strong evidence supporting treatment recommendations, there remains a large gap between recommended treatment and everyday clinical practice for many people who survive a cardiovascular event.

        Associate Professor Julie Redfern is leading work to address this issue in Australia and ultimately, internationally. Through this Future Leader Fellowship, she will continue to develop and evaluate new and existing strategies for increasing uptake of, and adherence to, long-term lifestyle change by people living with heart disease.

        Julie's research project includes policy development and media campaigns, as well as trialling electronic communication systems, such as text messaging and smart phone applications. She will also lead the pilot testing new approaches to preventive care, including providing incentives for people who take on and maintain healthy behaviours.

        Overall, this research will examine engagement with preventive care, evaluate the potential of new technologies, and implement a knowledge translation strategy.

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      • A smartphone application to support the control of high blood pressure

        Dr Elizabeth Dunford
        Dr Elizabeth Dunford
        Researcher: Dr Elizabeth Dunford
        Years Funded: 2015

        A high dietary salt intake increases the risk of high blood pressure and heart disease. Australians are consuming in excess of 9 grams of salt daily – well above the suggested intake of 4 grams for good health. Moreover, 3 million Australians have high blood pressure.

        With more than 75% of dietary salt coming from processed foods, it is important that consumers are aware of, and able to make, lower salt food choices. In Australia salt is currently labelled as ‘sodium’ on the nutrition information panel of processed food products. This can be confusing for consumers and research indicates that most shoppers are not aware of what constitutes a high or a low salt food choice.

        This project will investigate whether a novel smartphone application, SaltSwitch, is a useful tool to help consumers with hypertension to identify and purchase lower salt food products.

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      • South Australia and Northern Territory stroke study

        Associate Professor Timothy Kleinig
        Associate Professor Timothy Kleinig
        Researcher: Associate Professor Timothy Kleinig
        Years Funded: 2015

        Although broad health disparities between Aboriginal and Torres Strait Islander people and non-Indigenous Australians are recognised, the relative contribution of stroke is under-investigated.

        This research will advance knowledge of how stroke affects Indigenous Australians in several ways. It will firstly assess the quality of Indigenous identification and coding-based stroke diagnosis against 'gold standards' from previous prospective studies. It will use data linkage to quantify stroke risk in Indigenous South Australian and Northern Territory residents. An in-depth retrospective study of stroke among Indigenous Australians in central Australia will be performed, and a  stroke incidence study will be piloted.

        The research from this project will be used as a springboard for more detailed incidence and interventional studies.

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      • ’Stand Up for Health’ an intervention to reduce adolescent sitting time during the school day

        Dr Anne-Maree Parrish
        Dr Anne-Maree Parrish
        Researcher: Dr Anne-Maree Parrish
        Years Funded: 2014 - 2015

        In the first two years of high school adolescents spend more than half their day sitting. For girls, this increases to 70% by the middle two years of high school. High levels of sitting have been associated with poorer cardiovascular health in adults and adolescents, independent of the amount of physical activity undertaken.

        Dr Anne-Maree Parrish will conduct a pilot randomised controlled trial of an innovative, evidence-informed intervention to reduce sitting time and increase light-intensity physical activity during school hours among 12–14 year old adolescents. The study will involve 120 adolescents in the first two years of high school, from four schools, with two schools randomised to the intervention and two to the control group.

        Anne-Maree’s primary hypothesis is that over a six-month period, adolescents in the two schools randomised to the intervention group will show greater increases in their light-intensity physical activity and greater reductions in their sitting time compared to their control group peers.

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      • Structure and functional correlates in adult congenital heart disease

        Dr Preeti Choudhary
        Dr Preeti Choudhary
        Researcher: Dr Preeti Choudhary
        Years Funded: 2013 - 2015

        Improved paediatric surgical care and survival to adulthood has led to an exponential rise in adult patients with congenital heart disease presenting to cardiologists. As a result, they are a complex group, with long-term multi-system medical, surgical and psychosocial conditions and needs. Low patient numbers have limited research in this area and the evidence base is less solid than other areas of cardiology.

        Dr Preeti Choudhary will conduct a set of experiments to assess structural features via non-invasive cardiac magnetic resonance imaging (MRI) and compare them with cardiac functional impairment in a group of adult patients with congenital heart disease. This may enable earlier identification of high-risk patients and appropriate treatment strategies.

        These patients also exhibit a higher prevalence of ‘non-compaction’ (a spongy two-layered appearance) of heart muscle, which has been associated with heart failure, sudden death and stroke, although the cause and mechanisms are unknown.

        Preeti will study the likely contributing factors and the effect this has on heart mechanics and electrical conduction within the heart. Diagnostic criteria for this condition are controversial, and very few studies have linked diagnostic methods to outcome measures.

        In addition to assessing mechanical and electrical outcomes, Preeti aims to refine risk stratification measures by linking these measures to clinically important outcomes.

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    17. T

      • Targeted microbubbles for molecular ultrasound imaging and drug delivery

        Dr Xiaowei Wang
        Dr Xiaowei Wang
        Researcher: Dr Xiaowei Wang
        Years Funded: 2015 - 2016

        This project aims to develop targeted microbubbles that will provide a new range of applications in medical molecular ultrasound technology and targeted drug therapy.

        Antibody-coupled microbubbles directed against activated platelets (blood cells responsible for clot formation), activated endothelial cells (cells lining the inside of blood vessels) and fibrin (a protein that is essential for blood clot formation) will enable rapid molecular ultrasound imaging of blood clots, rupture-prone atherosclerotic plaques and inflammation. It will also facilitate targeted drug delivery.

        The advantages, low cost and general availability of ultrasound scanners, coupled with the emerging use of microbubbles, make the proposed technology both highly probable and promising as a future clinical application.

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      • Targeting atherosclerosis for imaging and therapy

        Assistant Professor Juliana Hamzah
        Assistant Professor Juliana Hamzah
        Researcher: Assistant Professor Juliana Hamzah
        Years Funded: 2013 - 2016

        Coronary heart disease due to hardening of the arteries, known as atherosclerosis, is a global health issue. Although remarkable advances have been made in diagnosing this disease, effective therapies in the clinic rely mainly on preventative measures to avoid onset. Targeting atherosclerotic plaques in the bloodstream locally for diagnosis and destruction remains a major challenge, partly due to the highly inaccessible environment of the plaques, which prevents the penetration of medicines

         Assistant Professor Juliana Hamzah’s research addresses this problem and explores a novel approach to accessing plaques and delivering therapy effectively while reducing severe side effects. She has recently developed novel substances that can specifically bind to atherosclerotic plaques. The plaque-homing substances use two peptides – LyP-1 and CREKA. LyP-1 penetrates deep inside plaques, while CREKA accumulates on the endothelia and plaque surface. These are both able to deliver large amounts of nanoparticles to specific targets in the plaques. Importantly, their targeting of plaques is specific. These peptides are not taken up by normal tissues.

        Juliana aims to effectively deliver imaging substances and therapeutics into plaques. Her research into multi-targeted, local therapy will enhance diagnosis and treatment of atherosclerosis.

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      • Targeting platelets for imaging of cardiovascular and inflammatory disease

        Dr Yung-Chih Chen
        Dr Yung-Chih Chen
        Researcher: Dr Yung-Chih Chen
        Years Funded: 2015 - 2016

        Heart attack and stroke, resulting from atherosclerotic disease, are major causes of death and disability in Australia, while rheumatoid arthritis has limited treatment options. Early diagnosis provides unique opportunities to improve disease outcomes. This project uses the latest molecular diagnostic imaging techniques to assess heart attack, stroke and rheumatoid arthritis. It uses a novel research model of atherosclerotic plaque rupture, which was recently developed and has since been widely adopted. 

        The first part of the project will focus on imaging the inflammation process and damage that occurs during plaque rupture and heart attack. And the final part, will investigate whether the same imaging tools can be used to detect early signs of rheumatoid arthritis before joint destruction develops. 

        Hence this project has the potential to deliver significant progresses in clinical outcomes. The project aims to reduce the burden of cardiovascular and inflammatory diseases on patients, the healthcare system and the community alike.

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      • ‘A-Team’: a team-based Facebook application to help adults get more physical activity

        Dr Carol Maher
        Dr Carol Maher
        Researcher: Dr Carol Maher
        Years Funded: 2014 - 2017

        Physical inactivity is a negative by-product of modern life. Over half of all Australian adults get less than 30 minutes of daily physical activity, which increases their risk of morbidity and mortality (illness and death) from coronary heart disease, stroke, hypertension and diabetes. Accessible and sustainable mass-reach interventions are needed to facilitate increased physical activity.

        Online social networking is enormously popular, with 11 million Australians regularly using Facebook. Additionally, the rise of smartphones has made it particularly accessible to groups traditionally disadvantaged in terms of internet access.

        Dr Carol Maher aims to exploit the reach, engagement and influence of social networking to increase physical activity. A Facebook application (app), ‘A-Team’, will engage users in a 50-day physical activity challenge with their friends, using a pedometer. Rather than simply tracking physical activity, the app is designed to be highly social and fun.

        This research will involve 400 Australian adults, although it has the potential to benefit many more. Positive findings could lead to relatively cheap dissemination on a mass scale. In particular, the intervention is well suited to women, people from low socioeconomic backgrounds and people who live in rural and remote areas. These groups are typified by high Facebook usage and low rates of physical activity. Moreover, this innovative intervention will serve as a model for other health interventions (e.g. diet, smoking).

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      • Telerehabilitation in people with chronic heart failure

        Ms Rita Hwang
        Ms Rita Hwang
        Researcher: Ms Rita Hwang
        Years Funded: 2014 - 2018

        Exercise has emerged as an effective and recommended intervention for people with heart failure. Despite this, many people are unable to access an exercise rehabilitation program for a number of reasons, including transport difficulties and program availability. Telerehabilitation, in which telecommunication technologies are used to provide heart failure rehabilitation programs within the home, is an alternative approach aimed at overcoming these barriers.

        Ms Rita Hwang will investigate the feasibility and effectiveness of telerehabilitation compared to a conventional rehabilitation program. Should telerehabilitation be found to be effective, it may directly benefit those people previously excluded from conventional programs, and offer an opportunity for people to receive rehabilitation in their own homes, overcoming many issues related to the access of services.

        Outcomes from this project may drive changes to service delivery, and improve cost and resource efficiency, with the broad effect of optimising outcomes for people with this condition in Australia. Rita's research will also assess the validity of remote assessment for people with heart failure.

        This innovative and novel approach has the potential to improve patient outcomes, and reduce the costs, travel time and waiting times for specialist services.

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      • Tenecteplase versus alteplase for stroke thrombolysis evaluation trial

        Associate Professor Mark Parsons
        Associate Professor Mark Parsons
        Researcher: Associate Professor Mark Parsons
        Years Funded: 2014 - 2018

        Associate Professor Mark Parsons has made two recent advances that could bring about a global transformation in acute stroke care. The first is the use of advanced brain imaging to identify potentially salvageable brain tissue surrounding the event the ischaemic penumbra. The second is the recent discovery in a Phase II trial that the new generation intravenous thrombolytic (blood clot-breaking) agent, tenecteplase, provides better outcomes clinically and in managing damage as blood flow returns to the affected area, when compared to the current standard blood clotbreaker, alteplase.

        Tenecteplase versus alteplase for stroke thrombolysis evaluation (TASTE), conceived and led by Associate Professor Parsons, is a large Phase III randomised trial designed to generate practice-changing evidence by applying the advanced imaging treatment selection approach used in his recent positive Phase II trial. TASTE aims to confirm the superiority of tenecteplase over alteplase in a broader group of stroke patients who are eligible for acute thrombolytic treatment in the current time window (less than 4.5 hours after stroke onset).

        TASTE will address crucial clinical and pathophysiologic questions in a much broader group of stroke patients eligible for acute thrombolytic therapy. A positive study result would be applicable to millions of people worldwide (including some 25% of the more than 30,000 Australians who present early with acute ischaemic stroke each year), and will undoubtedly directly translate into a major change in clinical practice.

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      • Testosterone and exercise (TEX): a new direction for older men?

        Professor Bu Yeap
        Professor Bu Yeap
        Researcher: Professor Bu Yeap
        Years Funded: 2015

        Testosterone levels fall as men grow older, and lower levels predict poorer health outcomes. However, it remains unclear whether giving testosterone to middle-aged or older men with low-normal levels would improve the function of blood vessels and the heart.

        Testosterone combined with exercise training improves muscle strength and performance more than either alone. This combination has not been tested for its effects on blood vessels and the heart.

        In this study we will examine whether testosterone and exercise training improves the function of blood vessels and the heart more than either alone, in middle-aged and older men who are overweight.

        These results will determine whether such treatments might reduce the risk of heart disease in men.

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      • Understanding affective disorders in stroke patients using neuroimaging

        Dr Pascal Molenberghs
        Dr Pascal Molenberghs
        Researcher: Dr Pascal Molenberghs
        Years Funded: 2015 - 2019

        Following a stroke, patients are routinely tested for perceptual, language and motor problems. However, they are rarely tested for problems that affect their social functioning, despite previous research having shown this to be a major problem in stroke patients.

        The aim of this project is to use a range of neuroimaging techniques to gain greater insight into the brain mechanisms that underlie social problems. This fundamental knowledge will form the basis for targeted interventions to improve the quality of life of stroke patients and their caregivers in the future.

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      • Understanding and treating life-threatening heart arrhythmias

        Dr Saurabh Kumar
        Dr Saurabh Kumar
        Researcher: Dr Saurabh Kumar
        Years Funded: 2013 - 2017

        Sudden death is a tragic occurrence that can affect Australians of all ages. Heart rhythm abnormalities (arrhythmias) are the most common cause of sudden death. Patients at risk are those with weakened heart muscles from either a prior heart attack(s) or inherited conditions. Heart pacemakers have been developed that can terminate these dangerous arrhythmias via electric shock, but they cannot prevent them from occurring. Medications can suppress arrhythmias but their effectiveness is markedly limited, they can have toxic side effects, and some medicines may even worsen the arrhythmia.

        A keyhole surgical procedure (‘ablation’) has been developed that may cure the arrhythmia by burning key components of arrhythmia circuits in the heart. However, this is only successful with 50% of patients. A solution is desperately needed to understand how arrhythmias occur, and methods of effectively treating and, more importantly, preventing them in the long term.

        Dr Saurabh Kumar will aim to understand irregularities in the heart muscle that cause dangerous heart rhythm abnormalities. He will study ways to improve the technology of ablation so that it can be used to prevent arrhythmias and improve the chance of a long-term successful cure. Saurabh’s research is likely to significantly improve quality of life and possibly improve the survival rate of Australians at risk of sudden death from these arrhythmias.

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      • Understanding how to promote physical activity and reduce sedentary behaviour

        Professor Anthony Okely
        Professor Anthony Okely
        Researcher: Professor Anthony Okely
        Years Funded: 2012 - 2016

        It is well known that excess body weight and a sedentary lifestyle lacking physical activity are associated with an increased risk of cardiovascular disease. It is also well documented that children and young adults in Australia are becoming more and more sedentary, which usually involves sitting for long periods of time. Obtaining adequate amounts of physical activity and reducing sedentary time are therefore very important to the future cardiovascular health of children and adolescents.

        Through his research, Associate Professor Anthony Okely will investigate the behaviour of children and adolescents to better understand their physical activity and sedentary behaviour patterns. Through more accurate measurements of physical activity and sedentary behaviour, this project will identify factors influencing participation in these behaviours, and it will design, implement and evaluate interventions to increase physical activity and reduce sedentary behaviour in young people.

        Anthony's research will enhance our understanding of how to promote physical activity and limit sedentary behaviour in our young people, which is vitally important for their short- and long-term cardiovascular health.

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      • Understanding the molecules that control vein and lymphatic vessel formation

        Dr Benjamin Hogan
        Dr Benjamin Hogan
        Researcher: Dr Benjamin Hogan
        Years Funded: 2015 - 2019

        Cardiovascular disease (CVD) affects 1 in 6 Australians during their lifetime and currently causes 31% of deaths in Australia. Vascular disorders make up a significant proportion of CVD and arise when the vasculature fails to form properly or fails to function properly. To treat vascular diseases when things go wrong, we first need to understand the genes and molecules that control normal vascular formation and function. 

        Dr Benjamin Hogan is investigating the genes that control the formation of new vasculature. He studies the formation of veins and lymphatic vessels, discovering new genes that control these processes. His previous work using this approach discovered the gene that causes the inherited vascular disorder Hennekam syndrome and he recently described how this controls new vessel formation. This discovery-driven approach has rapidly translated into new diagnostics in vascular disorders and novel therapeutic avenues.

        This project will use Ben's proven approach to discover and characterise the genetic networks that control formation of our veins and lymphatic vessels. The outcomes will include a greater understanding of how our vasculature is formed and the identification of a set of genes that control vessel formation. This will lead to potential diagnostic and therapeutic approaches in vascular disease

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      • Use of advanced cardiac imaging in radiation-related cardiotoxicity

        Dr Mark Nolan
        Dr Mark Nolan
        Researcher: Dr Mark Nolan
        Years Funded: 2015 - 2017

        Heart failure caused by radiation treatment for cancer represents a potentially preventable form of cardiomyopathy (disease of the heart muscle), as the at-risk population can be identified at the time of cardiac injury. However the cause is not well understood, which prevents us from being able to provide optimal protection of the heart.

        Our hypothesis is that radiation causes coronary endothelial damage, which is potentially preventable with early statin therapy. We plan to use echocardiography (diagnostic ultrasound imaging of the heart) to assess patients’ endothelial function by using coronary flow response to adenosine as a marker.

        We predict coronary flow reserve will be decreased in radiation-treated patients, and will improve after 12 months of statin therapy.

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      • Using advanced imaging to improve treatment of stroke

        Dr Bruce Campbell
        Dr Bruce Campbell
        Researcher: Dr Bruce Campbell
        Years Funded: 2012 - 2016

        Stroke is a major cause of death and disability in our community. The majority of strokes are caused by a blood clot blocking the blood supply to part of the brain (ischaemic stroke). Although some of the brain tissue will die almost immediately due to a lack of oxygen, a significant amount of the affected area is potentially salvageable if the blood supply can be restored quickly.

        Currently, people who suffer an ischaemic stroke are usually given medicines that help to dissolve the clot and restore the blood flow to the brain. Dr Bruce Campbell will investigate whether using a minimally invasive procedure to mechanically remove the clot, in addition to giving the standard clot-dissolving medicines, can make treatment more successful for some patients.

        Bruce's research will focus on using computed tomography (CT) scans to select patients with a large area of salvageable brain tissue, who are most likely to benefit from this approach. He will also try to identify those who are more likely to encounter complications from the treatment, such as excessive bleeding.

        Bruce's research may enable health professionals to quickly identify patients who are most likely to benefit from mechanical clot removal, and has the potential to save lives and improve quality of life for stroke survivors.

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      • Using computers and mathematics to model and predict cardiovascular disease

        Dr Michael Inouye
        Dr Michael Inouye
        Researcher: Dr Michael Inouye
        Years Funded: 2014 - 2018

        Genetic inheritance accounts for most cardiovascular disease (CVD) risk. The sequencing of the human genome has enabled the identification of genetic variants associated with CVD, however the challenges are now twofold. Firstly, how can genetic variants across the genome be combined to best capture CVD risk? Secondly, how does the genetic component of CVD actually cause disease? The answers to these questions have major ramifications for the clinical use of genetics for CVD, and for establishing target molecular pathways to 'short circuit' genetic risk.

        Dr Michael Inouye will model the genetic component of CVD using complex statistical approaches. He will discover and characterise transcriptional and metabolic networks in human blood that are associated with CVD. Finally he will integrate genomic risk with these molecular networks to model the pathways through which genetics gives rise to disease.

        Michael's research aims to produce scoring methods for CVD that capture genetic risk better than current approaches. This will lead to improved identification of high-risk individuals and prioritisation for early intervention strategies. His research also has the potential to uncover molecular network targets for therapeutic intervention.

        Finally, Michael is committed to open science and the role it can play in the fight against heart disease. Therefore he will make methodologies and software available free and open-source so all researchers can better manage, analyse and interpret their data.

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      • Using prompts to break occupational sitting time and improve heart health

        Dr Nicholas Gilson
        Dr Nicholas Gilson
        Researcher: Dr Nicholas Gilson
        Years Funded: 2014 - 2015

        Total occupational sitting time, and lack of breaks from prolonged occupational sitting, increases the risk of cardiovascular disease (CVD), obesity and type 2 diabetes. These relationships are independent of physical activity. Those who sit for long periods at work still have a heightened risk of what has been termed 'chair disease', even if achieving recognised physical activity guidelines.

        Office employees, the largest occupational group in Australia, are particularly exposed to the risk of CVD through occupational sitting. Evidence shows that these workers spend 75% of their day seated, usually at a desk completing computer-related work tasks. Effective and practical interventions that encourage office workers to integrate standing and moving breaks into work routines are urgently needed if sitting-related cardiovascular risk exposure is to be reduced.

        Dr Nicholas Gilsons novel study will test the feasibility of a new intervention device, the Sitting Pad. This device easily fits on office chairs, and provides second-by-second, day-by-day, real-time feedback to prompt breaks in prolonged periods of desk-based sitting. Over a four-month period, using objectively measured changes in desk-based sitting time, he will assess the extent to which the tailored feedback and prompt components of the Sitting Pad facilitate adoption of strategies that reduce and break prolonged sitting exposure at work desks.

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    19. W

      • What is the experience of Aboriginal and Torres Strait Islander patients in hospital following an acute cardiac event?

        Alex Brown
        Alex Brown Alex Brown
        Researcher: Alex Brown

        Whilst the in-hospital treatment disparities faced by Aboriginal and Torres Strait Islander people when accessing cardiac care are recognised, there is little understanding of what patients and their families would see as valued improvements, particularly in the area of patient and health professional communication.

        This project will explore the in-hospital communication experiences of urban, rural and remote Aboriginal and Torres Strait Islander cardiac patients, their families and health care providers.

        The study will produce a resource to help health care providers better understand the experiences of Aboriginal and Torres Strait Islander cardiac patients and will make recommendations on strategies to improve the health literacy of patients

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