Translational Vascular Function Research Collaborative

The Translational Vascular Function Research Collaborative undertakes basic, clinical and epidemiological studies into cardiovascular disorders with the objective of improving the health of these patients. Currently the group focuses upon coronary heart disease and peripheral artery disease, although many principles are applicable to other vascular disorders. We aim to conduct interdisciplinary research using a collaborative approach – with results being directly integrated into clinical practice where possible. The research group includes both physicians and medical scientists located at the Basil Hetzel Institute, The University of Adelaide Medical School and The Queen Elizabeth Hospital. The integrative nature of the group provides a unique opportunity to ensure that innovations are translated from bench to bedside to health outcome, as well as the reverse.

We welcome new students to join our group where they can be involved in a diverse range of projects with diverse opportunities. We offer exceptional supervising and mentoring, and provide opportunities for students to participate in vacation research electives, Honours or PhD programs. Our projects, available through the University of Adelaide, include:

innovative research studies harnessing knowledge from basic science to those identify new approaches to prevent, diagnose and treat cardiovascular disease, particularly in the emerging field of coronary microvascular dysfunction.

a strong focus on cardiovascular health care and patient outcomes with projects to ensure new treatments and research knowledge assist the patient and are implemented correctly.

the opportunity to improve health care quality by helping clinicians in their health-care decision making and strengthening the patient-clinician relationship.

Researchers

Professor John Beltrame
- Position: Lead Researcher
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Phone: +61 8 8222 6740
- Email: john.beltrame@adelaide.edu.au
- Profile: View profile
- UofA: John Beltrame
Professor Robert Fitridge
- Position: Lead Researcher
- Group: Translational Vascular Function Research Collaborative, Vascular Surgery Research Group
- Theme: Cardiovascular Disease
- Phone: +61 8 8222 7711
- Email: robert.fitridge@adelaide.edu.au
- Profile: View profile
Dr David Wilson
- Position: Lead Researcher
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: david.p.wilson@adelaide.edu.au
Associate Professor Chris Zeitz
- Position: Clinical Director
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: christopher.zeitz@sa.gov.au
Dr Prue Cowled
- Position: Principal Medical Scientist
- Group: Translational Vascular Function Research Collaborative, Vascular Surgery Research Group
- Theme: Cardiovascular Disease
- Phone: +61 8 8222 7541
- Email: prue.cowled@adelaide.edu.au
Dr Rosanna Tavella
- Position: Clinical Data Manager
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Phone: +61 8 8133 4011
- Email: rosanna.tavella@adelaide.edu.au
- Profile: View profile
- Research Gate: Rosanna Tavella
Dr Peter Zalewski
- Position: Senior Medical Scientist
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: peter.zalewski@adelaide.edu.au
- Profile: View profile
- UoA: Peter Zalewski
Zinaida Tvorogova
- Position: Research Assistant
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: zinaida.tvorogova@adelaide.edu.au
Dr Sivabaskari (Tharshy) Pasupathy
- Position: Postdoctoral Research Fellow
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Phone: +61 8 8222 7742
- Email: sivabaskari.pasupathy@adelaide.edu.au
- Profile: View profile
- Research Gate: Tharshy Pasupathy
Dr Anna Wawer
- Position: Postdoctoral Researcher
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: anna.wawer@adelaide.edu.au
- Profile: View profile
Dr Adrian Abdo
- Position: Research Officer
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: adrian.abdo@adelaide.edu.au
- Profile: View profile
- ResearchGate: Adrian Abdo

Students

Dr David Di Fiore
- Position: Student
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Profile: View profile
Dr Abdul Rauf Sheikh
- Position: Student
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: abdul.sheikh@sa.gov.au
- Profile: View profile
Clementine Labrosciano
- Position: Student
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Phone: +61 8 8222 7719
- Email: clementine.labrosciano@adelaide.edu.au
- Profile: View profile
- UoA: Clementine Labrosciano
Tracy Air
- Position: Student
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: tracy.air@adelaide.edu.au
- Profile: View profile
- ResearchGate: Tracy Air
Aakriti Lath
- Position: Student
- Group: Translational Vascular Function Research Collaborative
- Theme: Cardiovascular Disease
- Email: aakriti.lath@student.adelaide.edu.au
- Profile: View profile

Additional Research Staff Members

Name	Position	Email address

Carly Cilento	CADOSA Research Officer	carly.cilento@adelaide.edu.au
Michael Contibas	CADOSA Research Officer	michael.contibas@adelaide.edu.au
Bang Hoang	CADOSA Research Officer	bang.hoang@adelaide.edu.au
Dr Amenah Jaghoori	CALHN Scientific Officer	amenah.jaghoori@adelaide.edu.au
Rachel Jakobczak	CALHN Scientific Officer	rachel.jakobczak@adelaide.edu.au
Meredith Matthews	CADOSA Research Officer	meredith.matthews@sa.gov.au
Ellen Rees	CADOSA Research Officer	ellen.rees@sa.gov.au
Laura Simeone	CADOSA Research Officer	laura.simeone@sa.gov.au
Corrado Tavella	CADOSA Research Officer	corrado.tavella@adelaide.edu.au

Student Alumni (since 2016)

Name	Degree	Year Awarded	Thesis title	Supervisors	Scholarship

Victor Lamin	PhD, The University of Adelaide	2017	Molecular mechanisms of sex-differences in vascular reactivity of human internal mammary artery	Prof John Beltrame & Dr David Wilson	International Postgraduate Research Scholarships (IPRS, tuition fees) and an Australian Postgraduate Award (APA)
Tharshy Pasupathy	PhD, The University of Adelaide	2016	Novel clinical insights into myocardial infarction	Prof John Beltrame & Dr Rosanna Tavella	Australian Postgraduate Award (APA)

Professor John Beltrame: Student Research Projects for 2020

Project 1 Title: Coronary Angiogram Database of South Australia (CADOSA): Improving health outcomes in patients undergoing coronary angiography Description:Coronary angiography is the clinical benchmark technique in the assessment of coronary artery disease with more than 6,000 performed in South Australia each year. Despite its diagnostic benefits in identifying the presence of coronary disease, its benefit to the patient has been less rigorously studied and will be the focus of this project. CADOSA is an internationally renowned clinical registry incorporating global links with organizations including the American College of Cardiology National Cardiovascular Data Registry and the International Consortium of Health Outcomes Measurement (ICHOM). Projects Available: Honours and HDR Location: Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital Special Requirements: DCSI Clearance, Vaccinations The research project is available for semester 1 start though mid-year entry may be considered. Project 2 Title: Clinical and Vasomotor Studies of Patients with Myocardial Infarction and Non-Obstructive Coronary Arteries (MINOCA) Description: Approximately 5-10% of patients who experience a myocardial infarct do not have significant coronary artery disease, prompting the clinical question of what is the underlying mechanism? This project will (i) integrate with established registry studies to assess clinical outcomes and health status of MINOCA patients and (2) utilise invasive and non-invasive clinical techniques to elucidate potential mechanisms that may be responsible for the myocardial infarct. Projects Available: Honours and HDR Location: Basil Hetzel Institute for Translational Health Research, The Queen Elizabeth Hospital Special Requirements: DCSI Clearance, Vaccinations The research project is available for semester 1 start though mid-year entry may be considered.

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Molecular Physiology Projects

This group focuses on the pathophysiology and molecular signaling of vascular disorders. Laboratory studies include the assessment of isolated human vessel function using myography, followed by a series of biomolecular assays aimed to provide a mechanistic understanding of the disorders and thus direct the translation to improvements in medical therapy.

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Clinical Physiology Projects

This clinical research team utilises both invasive and/or non-invasive techniques to identify the presence of vascular dysfunction in patients with vascular symptoms including angina and intermittent claudication. These include the assessment of coronary artery spasm, coronary blood flow, cardiac magnetic resonance imaging, popliteal artery vasodilation, subcutaneous blood flow and endothelial function.

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South Australian Cardiovascular Outcomes Registry (SACOR)

This group focuses upon the health status of patients with vascular disorders including their symptomatic status, associated physical limitations and quality of life.

Consistent with the changing environment in medical research, this group adopts a ‘patient- orientated’ approach to the delivery of medical care in patients with vascular disorders by:

evaluating patient health status in population studies and
assessing the quality of care delivered

The group have developed large databases in patients with acute myocardial infarction, coronary artery and microvascular disease, coronary spasm, and peripheral artery disease. Most of these databases have international links thereby providing collaborative opportunities.

Improving Health Outcomes in Patients undergoing Coronary Angiography: Coronary angiography is the clinical benchmark technique in the assessment of coronary artery disease with more than 8,000 performed in South Australia each year. Despite its diagnostic benefits in identifying the presence of coronary disease, its benefit to the patient has been less rigorously studied and will be the focus of this project. Optimising the Quality of Care in Patients with ST Elevation Myocardial Infarction: ST Elevation Myocardial Infarction (STEMI) is a medical emergency for which effective therapies have been developed, although their implementation may need to be optimised. This project will identify treatment gaps in the management of STEMI and investigate potential system improvements.
Coronary Angiogram Database of South Australia (CADOSA): The Coronary Angiogram Database of South Australia (CADOSA) Registry was established to provide a comprehensive data infrastructure of invasive coronary procedures in order to evaluate the delivery of quality health care thereby facilitating clinical improvement and supporting clinical coronary research. The Registry now contains over 18,000 records, representative of public hospital clinical practice in the management of coronary artery disease. This unique Registry is attracting both national and international acclaim and continues to pioneer new innovations in clinical registry structure and function.
Assessment of Coronary artery disease using Computed tomography Effectively for Stable Symptoms (ACCESS): The ACCESS Project is a research study that endeavours to detect patients that are likely to have a normal coronary angiogram before they have the procedure and refer them for a new, less expensive and safer procedure called coronary CT angiography. This innovative study is an initiative of CALHN staff and has recently been awarded a prestigious NHMRC Partnership Project grant valued at $1.5 million, including contributions from CALHN and the Heart Foundation (SA Division). Utilising the innovative clinical and research resources within South Australia, we anticipate a major impact on cardiology practice with this project.
Health Outcomes in Patients with Intermittent Claudication: Intermittent claudication is the primary symptom of peripheral artery disease. It is the painful cramping in your leg muscles triggered by physical activity such as walking or climbing stairs. The pain usually goes away 5-10 minutes when you rest your legs. [Claudication is a latin term that loosely translates to 'limping'; source: HealthDirect Australia]. This project will examine the disability associated with this symptom and its impact on quality of life.
Myocardial infarction with non-obstructive coronary arteries (MINOCA): Myocardial infarction with non-obstructive coronary arteries (MINOCA) describes a heterogeneous subset of myocardial infarction (MI) or heart attack. In contrast to most of MI presentations where occluded coronary arteries observed, MINOCA patients are presented with symptoms suggestive of MI without occluded coronary arteries. MINOCA is associated to significant morbidity/mortality and conventional MI guideline therapy may not be appropriate for these patients since the underlying mechanism responsible for their apparent MI is unclear. This project will prospectively evaluate patients with MINOCA in relation to their clinical characteristics, potential pathophysiological mechanisms, contemporary discharge therapies, 12-month ischemic outcomes and health status. Importantly, we aim to provide direction for future interventional studies that will optimise the management of these patients.
The TIC (Ticagrelor In Coronary microvascular dysfunction) Program: Ticagrelor is one of several anti-platelet agents utilised in the management of acute coronary syndromes. Preliminary studies have also demonstrated that it can augment coronary blood flow by increasing adenosine levels, providing evidence for it pleiotropic effects beyond inhibition of platelet aggregation. The TIC (Ticagrelor In Coronary microvascular dysfunction) Program is a multi-centre 4-year research program that focuses on ticagrelor’s effect on the coronary microvasculature, particularly focussing on its potential clinical benefits in coronary microvascular dysfunction.

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also refer to p100 of BHI Research Report 2017

International standardization of diagnostic criteria for vasospastic angina

Beltrame JF, Crea F, Kaski JC, Ogawa H, Ong P, Sechtem U, Shimokawa H, Bairey Merz CN; Coronary Vasomotion Disorders International Study Group (COVADIS). International standardization of diagnostic criteria for vasospastic angina. Eur Heart J; 2015. Aug 4. pii: ehv351. [Epub ahead of print]

Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM)

McNamara RL, Spatz ES, Kelley TA, Stowell CJ, Beltrame J, Heidenreich P, Tresserras R, Jernberg T, Chua T, Morgan L, Panigrahi B, Rosas Ruiz A, Rumsfeld JS, Sadwin L, Schoeberl M, Shahian D, Weston C, Yeh R, Lewin . Standardized Outcome Measurement for Patients With Coronary Artery Disease: Consensus From the International Consortium for Health Outcomes Measurement (ICHOM). J Am Heart Assoc; 2015. 4(5): e001767.

Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries

Pasupathy S, Air T, Dreyer RP, Tavella R, Beltrame JF. Systematic review of patients presenting with suspected myocardial infarction and nonobstructive coronary arteries. Circulation; 2015. 131(10):861-70.

The prevalence of weekly angina among patients with chronic stable angina in primary care practices: The Coronary Artery Disease in General Practice (CADENCE) Study

Beltrame JF, Weekes AJ, Morgan C, Tavella R, Spertus JA. The prevalence of weekly angina among patients with chronic stable angina in primary care practices: The Coronary Artery Disease in General Practice (CADENCE) Study. Arch Intern Med; 2009.169(16): 1491-9.

The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon

Beltrame JF, Turner SP, Leslie SL, Solomon P, Freedman SB, Horowitz JD. The angiographic and clinical benefits of mibefradil in the coronary slow flow phenomenon. J Am Coll Cardiol; 2004. 44(1): 57-62.

Funding since 2010

Chief Investigators	Granting body	Project Title	Type of Grant	Total Grant Amount	Funding Period

Beltrame JF, Tavella R, Zeitz C, Spertus J, Arstall M, Worthley M, Chew D	NHMRC (#1062331)	Value-Based Healthcare in Elective Coronary Stenting	Partnership Grant	$2,440,223	2018 - 2021
Zalewski P, Hodge S, Beltrame J, Murgia C, Tavella R	NHMRC (#1138917)	Role for Zinc and ZIP2 in the action of nitric oxide and in vascular protection against cigarette smoke and cardiovascular disease	Project Grant	$685,941	2018 - 2020
Appleton S, Adams R, Beltrame J	The Hospital Research Foundation	Broken Sleep - Broken Heart? Longitudinal follow-up of cardiovascular and cognitive outcomes in middle aged and older men in North-West-Adelaide	Project Grant	$147,000	2018 - 2019
Dreyer R	NHMRC (#1111039)	Sex Differences in Long-Term Outcomes of Young Patients with Acute Myocardial Infarction	Sidney Sax Public Health Early Career Fellowship (Overseas)	$111,300 pa	2016 - 2019
Beltrame J, Zeitz C, Lindahl B	The Hospital Research Foundation (THRF)	Potential mechanisms and treatment of post-infarct angina in patients with Myocardial Infarction with Non Obstructive Coronary Arteries (MINOCA)	Basil Hetzel Translational Grant	$750,000	2017 - 2018
Beltrame JF	The University of Adelaide	The anti-anginal benefits of Zibotentan in the Coronary Slow Flow Phenomenon (CSFP)	Commercial Accelerator Scheme (CAS) Project	$87,000	2017 - 2018
Hodge S, Zalewski P, Roscioli E	NHMRC (#1099040)	Exploiting increased autophagy in bronchial epithelial cells: a new therapeutic approach for chronic obstructive pulmonary disease (COPD)	Project Grant	$745,390	2016 - 2018
Adams R, Appleton SL, McEvoy RD, Beltrame J	Heart Foundation	Cardiovascular impacts of obstructive sleep apnea in men	Vanguard	$75,000	2017
Tavella R, Beltrame JF, Zeitz C, Ranasinghe I	Heart Foundation	EVALuation of Appropriate UsE of Elective Percutaneous Coronary Intervention - Value of PCI	Vanguard	$75,000	2017
Tavella R	Heart Foundation (Tom Simpson Trust Fund)	Coronary Angiogram Database of South Australia (CADOSA) Biobank	Equipment Grant	$14,030	2017
Zalewski P, Hodge S, Beltrame J, Murgia C, Tavella R	The University of Adelaide	Endothelia zinc deficiency as a previously unrecognized factor linked to cardiovascular disease risk factors	Investment for Success NHMRC near-miss grant	$9,992	2017
Beltrame JF, Zeitz CJ, Worthley MI, Arstall MA, Tavella R	Astra Zeneca: ESR-14-10465	Ticagrelor In Coronary microvascular dysfunction (TIC) Program: Anti-anginal effficacy in primary coronary microvascular disorders	Project Grant	$300,000	2016 - 2017
Ranasinghe I, Beltrame J, Tavella R, Zeitz C, Mazumdar S, Cooper B	HCF Research Foundation: IRUA2015149	Reducing unwarranted variation in early complications after cardiac pacemaker and defibrillator implantation among Australian hospitals	Project Grant	$250,000	2016 - 2017
Beltrame JF, Zeitz CJ, Tavella R, Worthley MI	NHMRC (#1062331)	The ACCESS Project -Assessment of Coronary artery disease using Ct Effectively for Stable Symptoms	Partnership Grant	$1,564,165	2013 - 2017
Beltrame JF, Elliott A, Rajopadhyaya K, Fitridge R	The Hospital Research Foundation (THRF)	Exercise Therapy for the Management of the Coronary Slow Flow Phenomenon		$300,000	2014 - 2015
Beltrame J, Worthley S, Chew D	South Australian Cardiovascular Research Development	Chronic Refractory Angina - Defining its Characteristics and Exploring Endothelin Blockade as a New Potential Therapy	Program Grant	$1,327,652	2011 - 2014
Horowitz J, Beltrame J, Morris R, Fitridge R, Zeitz C, Wilson DP, Sallustio B, Chirkov Y, Kennedy J, Cowled P	The Hospital Research Foundation (THRF)	TQEH Vascular Disease and Therapeutics Research Group: towards improved outcomes for vascular diseases	Program Grant	$1,040,000	2009 - 2014
Tavella R	National Heart Foundation Tom Simpson Trust Fund	The Coronary Angiogram Database of South Australia (CADOSA) Biobank	Equipment Grant	$12,500	2014
Beltrame JF, Zeitz CJ, Worthley MI, Arstall MA, Tavella R	Astra Zeneca: ESR-14-10465	Ticagrelor In Coronary microvascular dysfunction (TIC) Program		$368,641	2014
Beltrame JF, Zeitz CJ, Worthley MI, Arstall MA	University of Adelaide, Discipline of Medicine	The Coronary Angiogram Database of South Australia (CADOSA) Biobank	Equipment Grant	$10,000	2013

Collaborator	Position	Institution	City	Country

Michael Worthington, James Edwards, Fabiano Viana, Robert Stuklis	Cardio Thoracic Surgical Unit (CTSU)	Royal Adelaide Hospital	Adelaide	Australia
Professor Andrew Tonkin	Head of Cardiovascular Research Unit	Department of Epidemiology and Preventive Medicine, Monash University	Melbourne	Australia
Dr Andrew Weekes	Medical Affairs Manager	Servier Laboratories		Australia
Professor Christopher Reid	Associate Director	Monash Centre of Cardiovascular Research and Education in Therapeutics	Melbourne	Australia
Professor C. Noel Bairey Merz	Medical Director	Cedars-Sinai Medical Centre	Los Angeles	USA
Professor John Spertus	Professor of Medicine & Director of Education and Cardiovascular Outcomes Research	University of Missouri, Kansas City & Mid America Heart Institute, St Luke’s Hospital	Kansas	USA
Professor Peter Ganz	Maurice Eliaser Jr Distinguished Professor of Cardiovascular Medicine & Chief, Division of Cardiology	San Francisco School of Medicine, University of California & San Francisco General Hospital	San Francisco	USA
Professor Harlan Krumholz	Harold H. Hines, Jr Professor of Medicine & Epidemiology & Public Health (Cardiology)	Department of Internal Medicine, School of Medicine, Yale University	New Haven	USA
Professor Attilio Maseri	President	Italian Heart Care Foundation	Florence	Italy
Professor Hiroaki Shimokawa	Professor and Chairman, Department of Cardiovascular Medicine	Graduate School of Medicine, Tohoku University	Sendai	Japan
Dr Guy Eslick	Research Fellow	Department of Epidemiology, Harvard School of Public Health	Boston	USA
Dr Caleb Stowell	Vice President of Standardization and Business Development	International Consortium for Health Outcomes Measurement (ICHOM), Harvard Business School, Boston Consulting Group & the Karolinska Institute	Boston & Stockholm	USA & Sweden
Dr Neil Oldridge	Senior Scientist & Director, Fellowship Training	College of Health Sciences, University of Wisconsin-Milwaukee & Heart Care Associates	Milwaukee	USA

Translational Vascular Function Research Collaborative

Researchers

Professor John Beltrame

Professor Robert Fitridge

Dr David Wilson

Associate Professor Chris Zeitz

Dr Prue Cowled

Dr Rosanna Tavella

Dr Peter Zalewski

Zinaida Tvorogova

Dr Sivabaskari (Tharshy) Pasupathy

Dr Anna Wawer

Dr Adrian Abdo

Students

Dr David Di Fiore

Dr Abdul Rauf Sheikh

Clementine Labrosciano

Tracy Air

Aakriti Lath

Additional Research Staff Members

Student Alumni (since 2016)

Funding since 2010