We spoke to Professor Barbara Casadei about her NHLI plans, Imperial's collaborative opportunities, and her enthusiasm for London’s vibrant art scene.

The National Heart and Lung Institute (NHLI) at Imperial has welcomed Professor Barbara Casadei as our new Head of Department. She joins Imperial from the University of Oxford where she was a British Heart Foundation (BHF) Professor of Cardiovascular Medicine, an Honorary Consultant in Cardiovascular Medicine at the Oxford University Hospitals NHS Trust, and the Lead of the Cardiovascular Theme of the NIHR Biomedical Research Centre.

She was the first female President of the European Society of Cardiology (ESC) where she established the European Cardiovascular Patient Forum, Women in the ESC (WinESC) and EuroHeart, an international collaboration that aims to advance the standard of care and build a European-wide infrastructure for pragmatic clinical trials. Professor Casadei has had a global impact on cardiovascular medicine, spearheading an internationally leading bench-to-bedside research programme on atrial fibrillation, spanning investigations from human tissue and cells to clinical trials. 

Welcome to Imperial! What attracted you to join NHLI and what excites you most about joining the community?

I’d say it’s the scale of the opportunities that cross-cutting collaborations within NHLI and across Imperial would bring to medical sciences and innovation. Imperial and NHLI already have a world-leading reputation in education as well as all the ingredients for training the discovery and clinical scientists of the future. That’s a huge attraction for me and it is my intention to expand the already excellent and diverse educational offering of the department by focusing on providing skills that would make our graduates ready to exploit the research opportunities and challenges that the future will bring. 

Another aspect that attracted me to Imperial is the University’s go-getting attitude which matches my love for innovation and disregard for complacency.

Finally, I have been impressed by the positive impact that my predecessor, Edwin Chilvers [previous Head of Department] at NHLI, and Jonathan Weber [previous Dean of the Faculty of Medicine] had on NHLI and the Faculty of Medicine culture and ecosystem. It shows that one person with a mission can make a big difference, and I find that very motivating. Deborah Ashby [current Dean of the Faculty of Medicine] and Clare Lloyd [previous interim Head of NHLI and Vice Dean for Institutional Affairs in the Faculty of Medicine] are building on that work with great energy and integrity – their values and the friendship and support they have offered me have also made this post very attractive.

Can you share a bit about your journey into cardiovascular medicine?

This is a classic question for someone my age! What I’ve noticed is that people often retrofit their journey to make it sound more planned and strategic than it was. In reality, much of one’s career is driven by chance encounters, resilience, and a particular type of luck, the one that happens when preparation meets opportunity, as the quote says.

I’m the first person in my family to go to university, and when I went, I didn’t have much of a clue about the opportunities that were open to me. It’s fair to say there wasn’t much career advice back then, at least in Italy. So my choices were largely influenced by the people I met – who inspired me, and who I wanted to learn from.

For example, I became a cardiologist because an Associate Professor in the Department of Medicine of the University of Pavia, where I was doing my medical student rotation, came back from a fellowship at the Brompton with the idea that left ventricular diastolic dysfunction, as measured by echocardiography, may be an important component of the heart failure syndrome – this is textbook material now but it was a very “daring” concept in 1984…!  I then came to Oxford for my clinical training, not intending to do research, but I got hooked and here we are, 35 years later.

My education has been driven entirely by inspiration. I believe in stimulating curiosity in students and young researchers, and it’s our responsibility to create an environment that’s inspiring, stimulating, and inclusive of different ways of thinking.

Tell us about your research – what are you currently focused on?

A variety of things. On the one hand I trained as a myocardial biologist and cellular electrophysiologist and through that I developed an interest in atrial fibrillation and diabetic cardiomyopathy. Half of my laboratory is focussed on mechanistic aspects that are pertinent to these diseases and the other half is working on imaging studies and clinical trials that aim to refine risk stratification in these patients or test new therapeutic strategies. I am also interested in building infrastructures (e.g., EuroHeart) that lead to improvements in quality of care for patients with cardiovascular disease, and allow high-quality observational studies and clinical trials to be conducted in a more cost-effective way across multiple geographies.

From the very beginning, I have been experimenting on human cardiac tissue – often samples from patients undergoing cardiac surgery -- as I believe it is important to identify and validate mechanisms in the relevant species. I love to collaborate with other scientists, because through collaborations I am constantly challenged to learn new things in a safer space than I would be if I tried to do that in isolation. I hope I will be able to inspire the up-and-coming investigators at NHLI to do the same and embrace the slightly uncomfortable feeling of venturing in fields and technologies where one is not an expert in order to chase new ideas.

"I enjoy the ‘eternal student’ status that collaborating with different people can give you"

Looking back, are there any moments or achievements that you’re most proud of?

What I’m most proud of is my research approach. People talk about going “from bench to bedside”, but I’ve truly embraced that since I completed my DPhil in 1994. Following an idea from a finding in human cells all the way to a clinical trial, has been both an exhilarating and sobering experience. Especially because, early on, I was advised I’d never succeed as an academic unless my research had a narrow focus. In the end, being aware of one’s strengths and preferences is more important than listening to advice.

Because of this, I’ve enjoyed my career journey enormously and I have learnt a lot from my senior colleagues and younger collaborators in equal measure. My experimental approach forces me to collaborate, which, as I have already said, I find is a fantastic opportunity to make friends and be alerted to new ways of thinking. I enjoy the ‘eternal student’ status that collaborating with different people can give you. 

As you step into this role at NHLI, what are your hopes and goals?

The sky’s the limit! Although there is so much excellence here already, I still see a lot of further potential. My mission is to unlock that potential by fostering an environment that encourages freedom, lateral thinking, and willingness to engage and to get out of one’s comfort zone.

It’s no secret that I’d like to see more cross-sectional collaborations, for example in areas such as inflammation and immunity, fibrosis, and models of human disease. I’d like to see researchers continue their fantastic research and talk to each other more across divisions and departments. There is a lot we can learn from each other and I’ll do my best to see that that potential is realised.

What are you most looking forward to about moving to London?

The theatre and music – assuming at some point I’ll have time for those. Whilst in Oxford, I was very envious of people who could just walk to the Wigmore Hall or the Proms… now it’s my turn! I also like to have long walks along the Thames – the river is so tidal in London that one walks in a continuously changing landscape and light. I have also developed an affection for the London irreverent parakeet community – I like the thought they have escaped their cages and now live in Kew Gardens… there is hope!

Do you have any book or theatre recommendations?

A book that’s been on my mind recently is Augustus by John Williams. Augustus was the founder of the Roman Empire which he ruled for more than 40 years. The book is about the tension between personal duties and public responsibilities, and what it means to leave a legacy that is over and above the land one occupies and the temples one might be able build. I’ve found it very relevant to my thinking about institutions.

As for theatre, I would recommend Dear England most strongly. The play is about building teams, overcoming fears, and empowering others. My husband was nervous about taking me to see this play because, on the surface, it’s about football. But I loved it – I wish I could bottle it and have it on my desk!