Professor Livia Hool is a champion of research and advocacy which aims to impact the global leading cause of death – cardiac disease.
By Ara Jansen
As a cardiovascular researcher, Professor Livia Hool certainly likes to get to the heart of the matter.
“I’m passionate about what I do,” says Livia. “Passionate about building a strong research community. I’m passionate about discovery research, which is ultimately what is essential for successful translation into clinical benefits.”
Livia loves the thrill of discovery. When she discovers something, she’s the first to find it and that really gives her a buzz.
“Then you have to clarify it and test it many different ways. If you are able to reproduce it under different conditions and confirm it, then that’s really exciting,” she says.
“People who come into this type of work are dedicated to finding something special. I think most people get involved in biomedical research because they want to make a difference.”
While details remain confidential, Livia’s team have helped develop a drug protocol which is heading into clinical trials. She has designed a protein that prevents an inherited heart disease from progressing.
Born and raised in Sydney, she has called Perth home for 26 years and has degrees in science, molecular biology and a PhD in cellular electrophysiology. She’s also the first woman to be awarded the Cardiac Society of Australia and New Zealand RT Hall Prize.
Livia’s mother was a pathology technician and spoke of her experience enthusiastically.
“She gave me a foundation for what it would be like to work in a hospital. Since I was young, I was fascinated by cardiovascular diseases as the leading cause of death. Later, I remember seeing people dying from breathlessness and thinking it was terrible. That sparked an interest in undertaking research in the area.”
She knew a number of doctors working in the field of blood pressure regulation and initially thought that what they were doing was interesting. After starting work in the field, she realised it wasn’t for her.
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In 1991 German physiologist Bert Sakmann and German biophysicist Erwin Neher won the Nobel Prize for Physiology or Medicine. The prize was awarded for “their discoveries concerning the function of single ion channels in cells” and development of the patch-clamp technique, a laboratory method now widely used in detecting tiny electrical currents in cell membranes.
This has revolutionised our understanding of the electrical activity responsible for the heartbeat and contraction of the heart muscle.
“When this came from Europe to Sydney, I saw it and thought I just had to have some of it. I literally crossed the corridor in the Cardiology Department and left my previous research work in this area, learning the patch-clamp technique and becoming one of the first researchers in the country to use it in my research.
“My interest in translational cardiovascular research came later. I have always loved physiology and in my undergraduate years I had some excellent lecturers who inspired me to learn about how the healthy body functions and what goes wrong with disease processes.”
Livia’s father died from a brain tumour when she was in Year 12. The positive to come from this was that it added to her curiosity at a scientific level and helped shape her interest in physiology.
“The heart is fascinating and once I found out about the patch-clamp technique I thought ‘I have to do this’. It was purely instinct. Here I was in Australia with the opportunity to learn about and use technology from Europe that had won a Nobel Prize.”
She decided to pursue a career in heart research after seeing how quickly heart attack patients deteriorated into heart failure.
Livia was the Gaston Bauer Cardiovascular Research Fellow in the Cellular Electrophysiology Laboratory at Sydney’s Royal North Shore Hospital from 1991-1995. Then she spent two years at Case Western Reserve University in Ohio as an American Heart Association Postdoctoral Fellow.
She’d already been fortunate to have travelled and presented her work at various conferences and was keen to widen her knowledge. She strongly advocates for researchers to travel, present their work, expand their knowledge, learn and live in other cultures for a while.
“When I came back to Australia it was quite usual thinking that the next step would be to use this knowledge in industry or in pharmaceuticals. Or establish a career as a research fellow.”
Livia took the research fellow path and has been raising money and funding her own position and that of her team for 30 years. She has raised more than $25 million towards her work understanding the excitation and contraction of the heart.
In that time too, success rates for grant funding have dropped from around 24% to 10%. Most grants or fellowships last five years, so typically in the fourth year she’s back applying for more funding, championing the feasibility of the work and its value.
Her team – eight to 10 researchers – is working on more than one project at a time as well, which offers diversity for funding opportunities.
Her lab is at UWA and in 2013 she joined the Victor Chang Cardiac Research Institute. For the last three years, Livia has held an endowed chair at UWA, supported by the university and Wesfarmers. She still has to raise money to fund her work and the team.
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As a passionate advocate for medical research funding, she was a founding director and secretary of the Australian Cardiovascular Alliance. In 2019 she also established and chairs the Western Australian Cardiovascular Research Alliance (WACRA).
The alliance advocates for increased awareness of cardiovascular disease and funding for cardiovascular research to stem the loss of capacity in research expertise as researchers leave the field.
“We don’t have an institute for cardiovascular research in WA, but researchers work across the five universities and research institutions, so WACRA has united researchers as a single voice to advocate.
“There is a lot still unknown about how cardiovascular disease occurs. For example, one in 100 babies are born with a congenital heart defect and we still don’t really know how that occurs. Also, we really are only just starting to understand the DNA and genetics related to the heart.
“With the inherited heart disease I study, one in 200 people carry a genetic mutation responsible for developing the disease. That’s shocking – it’s a lot of people. And we don’t know why some develop this disorder while others remain healthy but still carry the mutation.”
“Inherited cardiac disease is the leading cause of sudden cardiac death in five-to-15-year-olds – it’s more common than you think.”
These are some of the reasons Livia is known as a passionate educator and advocate to government for heart disease awareness and research, and has come to have a significant media presence.
Livia has found advocacy work fascinating and was involved in a WACRA submission to last year’s WA Parliamentary Inquiry about declining levels of health and medical investment in the State.
“I do a lot of advocacy and leadership. I want researchers in the field to feel they have a powerful and significant voice.”
She also sits on a number of committees and councils nationally and internationally.
The married mum of two university-aged children loves the coastline on this side of the country. A fan of the outdoors, she’s a regular swimmer, both in the pool and the ocean, and does a lot of walking and hiking in the South West. In colder climes she enjoys skiing – Japan is a favourite spot.
Livia travels regularly to deliver papers, speak at conferences and attend meetings interstate and overseas. Occasionally there’s the time and opportunity to discover new places. She says travelling to such events can pose a challenge for researchers from WA because of the distance, time and cost. Livia encourages her team to broaden their horizons this way.
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Preferring to work with her team in her lab rather than working from home, Livia goes in to UWA every day, something she and her team kept up during COVID.
“Our techniques require us to work on site, but it also meant we could focus as a team on the research which was good for morale. We were a rare group in that regard.”
The professor has been described as having a no-nonsense, down-to-earth approach. Livia says while she wouldn’t necessarily say that about herself, her science and research mind certainly helps her say what she means.
“There are times when you have to be very clear about what you stand for particularly with advocacy. You have some money and you have to decide what to do with it, you have to put it to the best use for the benefit of the community. People often assume academics are very competitive and automatically assume we’re doing it for ourselves.
“I love working with people. You can’t be an introvert doing what I do. I love working with people who share their stories about their lived experience. It’s a privilege to work to improve the lives and health of others.
“Even though everyone is trying to get money, with advocacy you can’t be in it for yourself, you have to be in it for everyone. Sometimes you just have to be very clear about that.”
Livia is also very clear that there’s plenty of work to do and she has plenty more questions to research for the rest of her already awarded career.
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