Vascular Biology - Projects


Inflammation- Platelet and Leukocyte Activation in CAD

Inflammatory mediation of endothelial dysfunction

Novel Measures of Haemostatic Function in cardiovascular and other diseases

Novel Intravascular Imaging Using Optical Coherence Tomography (OCT)

Cardiac dysfunction after pulmonary embolism and after clozapine

Choice of Health Options In Preventing Cardiac Events (CHOICE Study)

Atrial Fibrillation studies – SEARCH-AF and CHOICE-AF

Inflammation- Platelet and Leukocyte Activation in CAD

We have been studying the activation of white blood cells and platelets in people with coronary disease by taking blood samples from the circulation and from the blood vessels supplying the heart itself.

Dr Gabrielle Pennings has recently been investigating the effect of platelet mediated leukocyte activation in vitro with a specific interest in the effect of shear and the factors regulating CD147. Dr James Edelman has completed his PhD investigating the profiles of inflammation and coagulation after cardiac surgery. He has found both similarities and differences in the inflammatory response to conventional on-pump surgery and to off-pump surgery and sustained abnormalities of coagulation lasting weeks after cardiac surgery.


Inflammatory mediation of endothelial dysfunction

Serum Amyloid A (SAA) is an inflammation marker like CRP, and rises steeply during any inflammatory response. High levels of SAA predict cardiac events. Uncertainty remains as to whether SAA is a marker of risk or actually produces vascular damage. Work at the Anzac in prior years showed that SAA was highly pro-thrombotic and induced monoctyes and macrophages to produce tissue factor, the activator of all clotting. SAA was also released from the coronary circulation in patients with coronary artery disease. We have now shown that SAA also induces endothelial dysfunction, an early event and continuing aggravator in the development of atherosclerosis.


Novel Measures of Haemostatic Function in cardiovascular and other diseases

One of our interests is to study new ways of measuring haemostatic (blood clotting) function in patients with coronary disease, and in patients with an increased risk of blood clots such as those with certain kinds of cancer. New tests for platelet function and clotting established in our laboratory include the Overall Haemostatic Potential (OHP) assay, Calibrated Automated Thrombogram (CAT), platelet microvesicle formation, and platelet aggregation Detailed studies are being undertaken of patients having procedures such as coronary angiograms and in patients with multiple myeloma in collaboration with the Peter MacCallum Cancer Centre in Melbourne. These studies are being led by Dr Jennifer Curnow and Dr Reddel, in collaboration with Professors Brieger and Kritharides. The same assays are being successfully applied by Dr Reddel to animal models including tumour-bearing mice and mice subjected to surgical trauma.


Novel Intravascular Imaging Using Optical Coherence Tomography (OCT)

Our ongoing study of the novel technique of Optical Coherence Tomography (OCT) to image coronary arteries in vivo and in ex vivo experiments has led Dr Lowe’s students to investigate ways of ”flattening” the OCT images using computer analysis. This allows easy appreciation of the state of arteries, stent deployment and heterogeneity within stented segments.


Cardiac dysfunction after pulmonary embolism and after clozapine

Dr Chow’s long term follow up studies of patients with clots in the lungs (pulmonary embolism) have revealed a significant prevalence of pulmonary hypertension, weakness of the right side of the heart and restricted exercise capacity years after the index event. Our current guidelines for long term review of such patients may need be revised in view of his work undertaken under supervision of Professors Kritharides and Matthew Peters (and Drs Ng and Chung. In conjunction with colleagues from Croydon and Burwood psychiatric units, Dr Chow has investigated the incidence of cardiac dysfunction in patients taking clozapine and has found that mild dysfunction is very commonly seen in association with clozapine use.


Choice of Health Options In Preventing Cardiac Events (CHOICE Study)

Patients who survive a heart attack have a high risk of death or recurrent heart attack. Although this can be reduced by effective programs of secondary prevention like cardiac rehabilitation, many survivors do not access formal cardiac rehabilitation and have inadequately controlled risk factor levels. We developed a simple program called CHOICE, which allows patients to choose which risk factor(s) they will lower and how they will lower it. This very effective program has been extended in current studies examining whether a brief intervention is sufficient to produce long term changes over 2 years, or whether a longer program will be better in maintaining results. We enrolled almost 400 patients who survived a coronary event but elected not to participate in traditional cardiac rehabilitation and we have completed baseline, one and two year follow ups. This study was extended to include patients who are members of a health insurance fund as these funders are likely to provide resources for similar programs for their members. Following these patients will tell us if a brief intervention will have long lasting effects on multiple risk factors. This project is being led by Professor Freedman, Dr Redfern and Dr Neubeck.


Atrial Fibrillation studies – SEARCH-AF and CHOICE-AF

Atrial Fibrillation (AF) is the commonest cardiac arryhthmia, with a high risk of stroke and premature death, which can be largely prevented by anticoagulation. Many patients with AF are asymptomatic and AF is not discovered until they have a stroke. We have initiated a screening programme called SEARCH-AF to screen for AF in community pharmacies, and the study was completed in early 2013, showing that a novel iPhone application can record an ECG in and detect many cases of unknown AF. Another study modelled on the CHOICE program and adapted for patients with AF has been piloted to try to improve patient knowledge reduce anxiety about the condition, and improve compliance with medication.