Dear All,
My name is Nagesh Anavekar. I am a Cardiologist, Specialist in Cardiac Imaging, residing in Melbourne, Australia. I am Head of Cardiac Imaging at Northern Health and have academic appointments at The Baker Cardio-Metabolic Unit and The Florey Institute, University of Melbourne.
I completed my cardiology fellowship at Brigham & Women’s Hospital, Harvard Medical School, Boston, USA (2000-2004) under the mentorship of Prof Marc Pfeffer and Prof Scott D. Solomon. I was involved in managing the Echo Core Lab (for multi-centre international clinical trials) and was member of Clinical Trials Endpoints Committee (overseeing landmark trials: VALIANT, CHARM, PARADIGM, PARAGON TOPCAT etc).
My academic and research interests include Ventricular remodeling, Heart Failure, CardioRenal Syndrome, CardioHepatic Syndrome, GeroScience, Systems Biology, Information Theory, Complexity Theory, Molecular Biology, and Bioinformatics.
In particular, my focus is the intersection and integration of GeroScience with cardiovascular medicine; adopting a “systems engineering” approach to cardiovascular disease.
In this regard, I am working on several projects regarding muti-organ cross talk and ‘‘network science’’', applying these concepts to Heart Failure, as well as using such principles to create and assess more robust cardiovascular modeling, risk prediction metrics, with view towards earlier identification of disease and emphasis of preventative cardiology in the Cardio-Kidney-Metabolic domains.
Current approaches appear too ‘reductionist’ with limited appreciation and awareness of multi-organ cross talk and their significant influences, not only in initiating dysfunction, but also in perpetuating it.
In this regard, CV Medicine (my opinion) is confronting a 'therapeutic ceiling" with residual risk gap, as we are not incorporating the relevance of multi-organ inputs and outputs to the CV system; something, we should learn from Systems Biology and Engineering, e.g. an aeronautical engineer has detailed knowledge of all aspects of a Boeing 747, and they do not work in '‘silos’ having subspecialty focusses. When a plane fails, it is generally not because of a single major event, it usually the culmination of a series of small innocuous events across the plane or system, which over time approach a critical threshold where the system ultimately fails, resulting in a major catastrophic event. In similar regard, the human body is exponentially more complex than a Boeing 747, yet, in Medicine, the interaction and collaboration between various specialities, where various diseases overlap and share commonalities, is limited. Engineers view things in broad systems and “zoom out” first, before honing into a problem. We lack this approach in Medicine (my opinion). Furthermore, realising that there is a lag time before disease establishes itself, and having a systems approach, provides for earlier detection of dysfunction and supports ''precision" Medicine.
I seek any collaborations with anyone interested in what I have outlined above.
In particular, I seek to get more involved in data science, large dataset/registry focussed clinical research, in which I wish to assess the efficacy of various CV modeling (computational biology) and risk prediction models, using existing large datasets, as well as getting involved in meta-analyses.
In particular, conducting large scale clinical trials is becoming increasingly financially prohibitive, yet EMRs and digital health throughout the World provides for an untapped resource for data mining, and an alternative, more cost-effective strategy to conduct clinical research. It also, allows to test “proof of concept” work before considering the need for an expensive clinical trial.
I feel OHDSI aligns with my research interests, and I wish to collaborate, assist, and help in any way I can. I am at your service.
Kind regards
Nagesh