Recent Achievements

Recent Achievements

The MCRC Group has continued to enhance its existing high international profile in cardiovascular medicine and physiology with group members making major contributions to:

1. factors influencing arterial function in health and disease and in developing the concept of “ventriculo-vascular” interaction (major work on arterial transfer functions and aortic pressure wave propagation and clinical applicability of assessment of arterial function);
2. endovascular, transcatheter cardiological therapeutics (first-in-man drug eluting stent studies, advice to government bodies).
3. new techniques in cardiac surgery

As a combined research group of MonashHEART/Cardiothoracic Surgery, it is worthwhile considering the context in which the MCRC operates. Large artery disease and dysfunction is an underlying and unifying process in very significant proportion, possibly the majority, of the various clinical manifestations of the diverse presentations seen in cardiovascular medicine.  Large artery stiffening is also the pathology responsible for isolated systolic hypertension, the most prevalent form of hypertension in those >60 years of age. Arterial function decreases with insulin resistance syndromes and diabetes and is responsible for a significant component of the morbidity associated with obesity and the metabolic syndrome. With the predicted obesity epidemic about to dawn in the Australian community, large artery dysfunction and its associated clinical presentations will increase in prevalence and importance. MCRC research involves investigations of optimal strategies for prevention and treatment of coronary, cerebral and peripheral arterial disease, an improved understanding of atherobiology and assessment of large artery pathophysiology and secondary dysfunction. Translation of this research into clinical practice is aimed at identification of risk, guidance as to choice of appropriate therapy and assessment of response to treatment.

In established coronary disease, surgical and percutaneous treatment is the main treatment modality of acute and chronic coronary syndromes, with increasing use of innovative surgical techniques and the continuing evolution of new techniques of percutaneous cardiac intervention. Applied and translational researchers within MCRC continue to interact closely with the pharmaceutical and therapeutic device industry including in proof-of-concept and first-in-man studies of percutaneous delivery of coronary therapeutics.

Through publication and participation in international societies and scientific forums MCRC group members are acknowledged opinion leaders. Dr Sandy Prasad, an MD student and clinical research fellow, in the centre was invited to present at the prestigious Trans Catheter Therapeutics Conference in Washington DC, USA. Such activities ensure MCRC researchers are internationally recognized in the field of in-vivo cardiovascular research in humans, in particular for their contribution to the better understanding of treatment modalities for coronary artery disease and the interaction of the heart and the systemic arterial system. It is particularly pleasing to report that these activities also ensure that the MCRC continues to attract the best quality young researchers and clinical fellows nationally and from overseas.

Interventional Cardiology and Endovascular, Trans-Catheter Coronary and Cardiac Therapeutics. (Prof I Meredith, Dr P Antonis, Dr Y Malaiapan, Prof Richard Harper)

Research into effective treatment of coronary artery disease and other cardiac conditions by percutaneous trans-catheter intervention established and lead by Professor Ian Meredith is built on extensive research expertise in human in vivo coronary physiology, most recently with the first direct demonstration of the effect of aortic stiffness on coronary blood flow. Continued basic and applied research activity in this area has seen the MCRC group established as a recognized international centre of translational research into new percutaneous treatment modalities (eg lead site of the ENDEAVOR 1 and ENDEAVOR CR RESOLUTE international multicentre trials of zotorolamus eluting coronary artery stents that have become standard transcatheter therapeutic devices). MCRC members have pioneered new percutaneous and surgical cardiac procedures including the introduction of alcohol ablation for percutaneous transcutaneous septal myocardial ablation (PTSMA) to Australia.

New Techniques in Cardiac Surgery (Prof J Smith, Mr A Almeida, Mr A Cochrane, Mr J Goldstein)

Cardiothoracic surgery research is in the field of cardiac surgery without the use of cardiopulmonary bypass, new devices in artificial heart technology, and the establishment and evaluation of techniques and instrumentation for minimally invasive surgery, robotic-assisted surgery and microsurgery and evaluation of outcomes in respect to these new technologies. There is also significant on-going work on modelling and deformation analysis of human organs and the use of virtual reality-based techniques for surgical training and pre-operative planning of surgical procedures.