Lofty Goals at High Altitude: The Grover Conferences, 1984–2011

Dr. Reeves and his colleagues, Drs. Wiltz Wagner, Norbert Voelkel, Ivan McMurtry and Ken Weir (Fig. 3), recognized the need for an ongoing international, scientific conference devoted to the pulmonary circulation. The meeting in 2011 was the 15th in the series. Those who study the pulmonary circulation do not need to be reminded of its unique characteristics. However, the great majority of the non-medical public are still in the pre-Harveian era and do not know that there is an entirely separate circulation of blood to the lungs. Few of those who are medically trained, other than cardiologists and pulmonologists, remember the complex embryology that gives rise to the proximal, capacitance, pulmonary arteries. Many have forgotten that the pulmonary vasculature is a low-pressure system, accommodating the entire cardiac output and interfacing with the airways down to the level of the alveoli, with the bronchial circulation and with the lymphatics. Those who work in the area know that the lungs provide a large area of contact between the blood and endothelium and consequently, the lungs’ metabolic activity is enormously important. Many endogenous substances are activated, such as angiotensin l, or inactivated, such as bradykinin; and yet others, such as nitric oxide and prostacyclin, are generated by the endothelium of the pulmonary vasculature. In most respects, the pulmonary circulation is quite different from the systemic circulation, as illustrated in terms of acute reactivity by hypoxic pulmonary vasoconstriction, in altered function by the potentially fatal condition, high-altitude pulmonary edema, and in chronic disease by idiopathic pulmonary arterial hypertension. It is clear from even a brief summary of ORIGIN