By Tim Shea 

At the heart of VCU Health’s mission lies a commitment to groundbreaking research, community engagement, and patient-centered care.  

Now, two trailblazing research projects funded by the American Heart Association (AHA) are bridging the gaps for patients who face the life-threatening challenges of cardiovascular disease. Together, these efforts aim to improve access to care, reduce disparities and enhance outcomes for patients, whether they face the daily toll of chronic stress or the sudden peril of cardiac arrest. 

Mapping chronic stress to prevent cardiovascular disease 

Thanks to a $15 million grant from the AHA’s Strategically Focused Research Network program, VCU Health Pauley Heart Center is investigating the molecular underpinnings of how chronic stress impacts cardiovascular health. This study – the first of its kind at Virginia Commonwealth University – seeks to uncover the physiological effects of prolonged periods of stress and develop effective, real-world solutions for vulnerable populations. 

“Stress isn’t just a mental burden,” explains Gregory Hundley, M.D., director of the Pauley Heart Center. “It’s also a physiological one.” 

The research project integrates expertise from Pauley Heart Center and VCU School of Medicine’s departments of Psychiatry and Internal Medicine, as well as the Department of Kinesiology and Health Sciences in the College of Humanities and Sciences. Together, the team is investigating how different diet and exercise plans might serve as a treatment for stress-induced cardiovascular damage, particularly in cancer patients.  

Our strength lies in our ability to bring together experts across disciplines to tackle big questions. With the trust of our community and the support of visionary donors, we are paving the way for a healthier future. 

Gregory Hundley, M.D., director of the VCU Health Pauley Heart Center 

Psychiatry professor and Wright Center for Clinical and Translational Research Director F. Gerard Moeller, M.D., brings to the team expertise in brain imaging, allowing researchers to map how different stressors influence brain activity and, by extension, cardiovascular health. Imaging of the brain helps them delve into the brain’s role as an intermediary in the body’s stress response – commonly called the fight-or-flight system – to see how stress-induced brain activation leads to systemic inflammation and heart disease.  

"We’re studying what happens at the cellular level, how inflammation is triggered and how stress impacts brain activity, which in turn affects the heart," Hundley said. "This team science approach allows us to explore these interactions in unprecedented detail." 

Fadi N. Salloum, Ph.D, associate chair for research in the Department of Internal Medicine and associate director of research mentoring and preclinical science at the Pauley Heart Center, leads efforts to understand cellular responses to stress and develop targeted interventions to prevent inflammatory damage to cells that lead to conditions like heart attacks and strokes. 

A critical component of the research is the behavioral element led by Arnethea Sutton, Ph.D., assistant professor in the Department of Kinesiology and Health Sciences and member of a Pauley Heart Center clinical research team, who collaborates with community advisory boards to help investigators explore how physical activity can buffer against stress-related damage. 

Revolutionizing emergency cardiac care with drone technology 

Meanwhile, a technological revolution is taking flight in James City County, Virginia. A pioneering project will be testing drones as a faster means of delivering automated external defibrillators to bystanders so they can treat out-of-hospital cardiac arrest victims before first responders can get to the scene. 

Every year, more than 350,000 Americans experience sudden cardiac arrest, with survival chances dropping 10% with each minute of delay to treatment. If defibrillation occurs within the first minute, survival rates are as high as 90%. However, traditional emergency medical services responders often take 8 to 10 minutes to reach a patient and several more minutes before they can attach their equipment and, if indicated, deliver a defibrillation shock to restart the heart. 

“The enemy is time to initial treatment,” said Joseph P. Ornato, M.D., professor in the Department of Emergency Medicine at VCU School of Medicine and physician at VCU Medical Center, who is leading the project. “The effectiveness of rapid treatment is high, and although our emergency care providers are well trained, the critical issue is how long it takes to reach the patient.” 

Nearly a decade ago, Ornato secured a National Institutes of Health grant to explore drone delivery of lifesaving treatments, such as naloxone for opioid overdoses and AEDs for cardiac arrest. For the study, his team trained Richmond’s 911 medical dispatchers as Federal Aviation Administration-certified drone pilots, equipping them with the skills to operate drones in emergencies – demonstrating the potential for drones to accelerate critical interventions.  

Ornato, an experienced physician-scientist and instrument-rated jet and drone pilot, has a long history of innovation. More than two decades ago, he and his wife, Pauley Heart Center cardiologist Mary Ann Peberdy, M.D., led a clinical trial that secured FDA approval for public access to AEDs. This breakthrough made AEDs widely available in public spaces, saving an estimated 10,000 lives in the United States each year. Building on that legacy, Ornato saw an opportunity to harness advances in drone technology to improve the life-or-death urgency of cardiac arrest care. 

“During the naloxone trial, I noticed that some of the new drones coming on the market were larger, faster and safer,” Ornato said. “I thought, ‘What if we could use them to deliver AEDs?’” 

After calling 911, bystanders will receive step-by-step instructions for performing CPR and using the AED until first responders arrive (Forsyth County, NC Sheriff’s Office).

That’s when Bob and Margaret Hershberger of Williamsburg, Virginia, stepped in to fund a feasibility study demonstrating the concept’s viability. The couple has a deeply personal connection to cardiovascular research – Bob suffered a cardiac arrest while exercising, and Peberdy saved his life. 

“The Hershbergers are hero public citizens,” Ornato said. “Without their support, we’d have nothing more than a dream in our heads.” 

Based on their support, the VCU team was able to press forward and demonstrate the potential of drone-delivered AEDs – a development that positioned them to collaborate with a colleague at Duke University. Together, they secured a $4 million AHA grant.  

As part of the grant, the team was required to launch the project in less densely populated areas, where innovative solutions could help bridge gaps in emergency care. The Duke team selected Forsyth County, North Carolina, while the VCU team chose James City County, just outside Williamsburg. 

Now, 18 months into the project, both sites have secured the necessary FAA certifications, and AED drone deliveries are set to begin within months – nearly a year ahead of schedule. The lessons learned from this initiative will serve as a model for expanding FAA-approved drone-delivered AED services nationwide, helping more cardiac arrest victims receive lifesaving care when every second counts. 

A unified vision for better cardiovascular care 

From exploring the molecular impacts of stress to deploying leading-edge drone technology, VCU Health is advancing innovative solutions to today’s most pressing cardiovascular challenges. Both initiatives exemplify the power of collaboration, philanthropy and patient-centered research. 

“Our strength lies in our ability to bring together experts across disciplines to tackle big questions,” Hundley said. “With the trust of our community and the support of visionary donors, we are paving the way for a healthier future.”  

Learn more about our innovative researchers and their projects

A version of this story was originally published by VCU School of Medicine