The HRI is excited to announce that the highly accomplished Professor Stuart Grieve has been appointed to lead the new Cardiac Imaging Group.
A dynamic and dedicated clinician and researcher, Stuart holds several appointments, most notably as Professor of Radiology at the University of Sydney and Clinical Academic Radiologist at the Royal Prince Alfred Hospital. Stuart is also Director of Imaging at the Charles Perkins Centre, University of Sydney.
The new Cardiac Imaging Group studies the full spectrum of translational imaging, from basic science imaging through to pure clinical innovation and translation.
“Our research focuses on the application of cutting-edge imaging technology to improve our understanding of heart function. We look at the basic pathophysiology behind different cardiovascular diseases, creating images that faithfully reflect these processes,” Stuart explained.
While the group use imaging techniques to understand the basis of cardiac disease, their ultimate aim is to use this knowledge to improve patient care. “We’re aiming to make very sensitive and specific tests that can help with clinical decision making,” said Stuart. “We hope to improve the precision and ease of diagnosis and help predict treatment outcomes.”
The Cardiac Imaging Group consists of Stuart, three post-doctoral fellows, a number of graduate students and a network of highly engaged clinical collaborators across a number of Sydney hospitals. Dr Fraser Callaghan is the founding senior post-doctoral fellow, a fluid mechanical engineer who has built an impressive platform of technical innovation from which the group can launch their research. The group is already one of the leading laboratories in the world in which to study quantitative cardiac imaging.
A major focus of the group is the development of 4-dimensional flow magnetic resonance imaging (4D-flow MRI), a unique form of MRI that measures the fluid dynamics within the heart and vessels in a quick and non-invasive way. Recent advances in technology have made 4D-flow more feasible and Stuart believes that the science is on the cusp of great change. “This technology is set to revolutionise not just cardiac imaging, but the daily practice of cardiology. The information that will be possible is far superior to anything that is currently available,” Stuart explained.
Stuart’s diverse skill set, combining technical MRI expertise with a strong clinical and biochemical background, places him in a unique position to act as a key collaborator in the field. As evidence of this particular strength, the group has extensive collaborations with several physician-researchers and hospitals across Sydney.
Stuart believes collaboration has many advantages, improving the research process to better define and address clinical problems, and educating clinicians on the potential of the technology. One key collaborator is Professor David Celermajer of the Clinical Research Group at the HRI, who has co-authored two papers with the Cardiac Imaging Group. Stuart describes David as both a mentor and collaborator, and they are currently working together towards employing 4D-flow imaging to characterise congenital heart disease.
Several cardiac conditions are of interest to the group, including the looming epidemic of diabetes-related diastolic heart failure. Generally, heart failure is only clinically apparent once the disease process is advanced, leaving the clinician with limited treatment options. Currently, echocardiography is the mainstay for diagnosis but there is increasing recognition that this is a very subjective test, limiting widespread precise application. The group are busy developing a suite of techniques, including 4D-flow technology, that are better able to diagnose this condition in its early, preclinical stages.
The group is also concerned with aortic valve replacement, and are pioneering a way of predicting the likelihood of emboli from measuring the fluid sheer stress in the aorta. In aortic valve replacement the prevalence of clinical stroke is estimated at 1-3% but when measured with brain MRI, the prevalence is much greater at a staggering 75%. Stuart is excited by this project as it integrates his interest in both cardiac and neuroimaging.
Stuart’s work in neuroimaging has contributed to the understanding of brain structure and function and more specifically, the brain networks involved in depression. He has led the largest imaging study of treatment response in depression, an investigation that has already yielded a series of seminal papers on the topic. “Collectively, these papers present the most compelling use of imaging to predict treatment response in depression,” said Stuart. “These papers are the first to offer imaging as a realistic tool to guide treatment choice in this condition.”
It is also becoming well recognised that many cardiovascular conditions, including hypertension, heart failure and diabetes, result in profound brain changes that can lead to cognitive and emotional dysfunction. Technological limitations have meant that these changes have not been studied at a structural level before now. With recent improvements in technology, Stuart now hopes to add real value to this area of cardiovascular research.
Another key project of the group is the study of neurogenic hypertension, high blood pressure arising from changes in the brain, in collaboration with Professor Gemma Figtree at the Kolling Institute at Royal North Shore Hospital. Presently, neurogenic hypertension is not effectively treated because current medications do not act centrally in the brain to treat the underlying cause. The Cardiac Imaging group are using several techniques to look at the circuits in the brain stem and hypothalamous that directly modulate sympathetic tone, which is thought to be the key driver of neurogenic hypertension.
Stuart is enthusiastic about his work, “I love to see great science and I’m absolutely driven to improve patient care.” He finds the HRI a uniquely attractive institution for his work. “The HRI is full of great collaborators and the leadership team is supportive and dedicated to making our research successful,” Stuart explained.
Stuart’s stratospheric rise began with a Bachelor of Science in Biochemistry at the University of Sydney, studying basic biophysics using Nuclear Magnetic Resonance (NMR) under his supervisor and mentor Professor Philip Kuchel, for which he received first class Honours.
Stuart was then awarded a prestigious Rhodes Scholarship to complete his Doctor of Philosophy at the University of Oxford, England. There he developed and validated rapid imaging techniques in MRI for application to the brain alongside Professors Andy Blamire and Peter Styles.
He then spent several years in post-doctoral research with Professor Tony Watts also at the University of Oxford, where his studied the application of solid state NMR to membrane-bound proteins, and pioneered mouse cardiac MRI.
Returning to Australia, Stuart completed his medical training at the University of Sydney, while undertaking independent research and contributing to his field at an international level.
Over 20 years of active research, Stuart has achieved a comprehensive understanding of MRI and its applications, from cellular biochemistry and physiology to MRI physics, programming and advanced image analysis techniques. More recently, Stuart has steadily built on this solid research foundation, using cardiac MRI to characterise heart disease and ventricular function.
Stuart has successfully won several competitive grants including 4 NHMRC project grants. He has published over 90 papers in the top ranking journals, including Neuroimage, Journal of Biological Psychiatry, American Journal of Neuroradiology and the European Heart Journal. As evidence of the significance of his work, he has an H-index of 29 and his published papers have generated more than 2,600 citations.
Stuart is committed to educating others, with extensive experience supervising post-graduate students in a scientific research environment, and the clinical teaching of radiology registrars, basic physician trainees and medical students at the Royal Prince Alfred Hospital.
Stuart grew up in a small town in country NSW, before attending boarding school in Sydney. Both parents being biochemists, Stuart credits them with encouraging his inquiring mind and helping him with numerous home experiments as a child.
An intriguing mixture of relaxed and intense personality traits, Stuart spends his leisure time with his young family and keeping fit through cycling and running. He also enjoys travelling in Tuscany, Italy and keeping a salt water aquarium.
Talented and ambitious, Stuart is driven to making real impact in medical imaging. “My goals over the next five years are to establish myself as a preeminent cardiac and neuroradiology researcher on the international stage, to play a key strategic role in imaging research within the university hospital network and to establish my research group as the premier imaging group in the Southern Hemisphere.”