Billman's research has focused on
cardiovascular physiology with an emphasis on
ventricular fibrillation (VF) and the
cardiovascular system's response to
stress. His work has led to non-invasive (
electrocardiograph) techniques to detect susceptibility to
sudden cardiac death (SCD) in dogs. These electrocardiographic markers have subsequently been used clinically on humans. He has also studied the effects of exercise training and novel pharmaceutics on the test subject's susceptibility to fatal
cardiac arrhythmias. He has performed experiments on live research dogs and using isolated ventricular
myocytes. The model subsequently has been described as "an elegant in vivo model of sudden cardiac death" by cardiologist Michel de Lorgeril
et al. and "a highly reliable canine model of sudden cardiac death" by physiologist Alexander Leaf
et al. The model is described in
Springer's handbook of reliable procedures for testing the potential effects of new drug candidates in the antiarrhythmic section. In the procedure, the left main anterior
coronary artery is surgically blocked, and a hydraulic cuff is placed around the left circumflex coronary artery, allowing the artery to be blocked on demand. Experiments proceed after a month of recovery and treadmill training. These dogs are labeled susceptible, while the other 40–50% are labeled resistant. The initial study using the technique, published in 1982, found that decreased
baroreflex sensitivity was associated with increased risk for ventricular fibrillation. This marked the first time an
autonomic response was seen as having prognostic value. The same association was demonstrated in humans by Kleiger
et al. in 1987 and "definitively" demonstrated in dogs in 1988 by Schwartz, Billman,
et al. Billman's model of SCD has also shown that sudden death is not a direct function of the degree of a myocardial infarction and that baroreflex gain declines during MI. Resistant dogs show a reduced heart rate during ischemia, while susceptible dogs show increased heart rate (beyond that induced by the exercise). Reviewing the findings, physiologist
Dwain L. Eckberg wrote that the model "seems to be extremely relevant" to human patients at risk for sudden cardiac death.
Omega-3 fatty acids In 1994, Billman used his model of SCD to test the ability of omega-3 polyunsaturated fatty acids to prevent fatal arrhythmias. In the test, eight dogs otherwise susceptible to ventricular fibrillation were given a direct infusion of
fish oil. Seven of the eight did not have VF during the test. Five of five animals retested in a follow-up control test (i.e, without treatment) had VF. The observed effect most likely resulted from a combination of direct chemical interaction on the cardiac cell membrane and a reduced heart rate caused by the omega-3s. Follow-up studies in 1997 and 1999 confirmed the results (
P<0.005) and found both
eicosapentaenoic acid and
docosahexaenoic acid (found in fish oil), as well as
α-Linolenic acid (found in vegetable oil) to have antiarrhythmic effects. The same effect has been shown to occur in humans by other researchers. Billman's more recent work has focused on discovering the biochemical mechanisms of the antiarrhythmic effects of omega-3 fatty acids and on whether the same protection can be gained through dietary omega-3 fatty acids.
Response to research Billman's experiments have been protested by animal rights activists. In 2007, a local group known as Protect Our Earth's Treasures, spurred by Ohio State approving the use of up to 120 additional dogs, protested Billman's research. Specifically, they were against the surgical blocking of arteries in Billman's model of sudden cardiac death and the subsequent euthanizing of surviving animals for future study. Two federal investigations found no evidence of wrongdoing, but PETA continued to campaign against the experiments. Billman received a new investigator award from the National Institutes of Health (NIH) from 1983−1986. He was the principal investigator on NIH R01 grants starting in 1986, 1995, 2002, and 2007, and on a
National Institute on Drug Abuse R01 grant starting in 1990. He has also led studies paid for by
Hoffmann-La Roche,
Merck, and Sanofi-Aventis. ==Personal life==