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Bertron M. Groves, MD: Visionary
Builder of Bridges Between
Cardiologists and Pulmonologists
Through Hemodynamics
 Whether
voluminous or brief, a curriculum vitae (CV) serves as
a road map to one’s medical career, charting the stepping
stones through internship, fellowship, appointments, awards,
publications, and speaking engagements.
But the CV of Bertron M.Groves, MD,
Professor of Medicine, University of
Colorado Health Sciences Center, Denver,
is much more. The entries—namely,
the distinguished list of peer-reviewed and landmark publications—
not only track the path he followed but signify
milestones for all clinicians in the study of the relationship
between hemodynamics and pulmonary hypertension.
Much of the work done by Dr Groves sprouted from the
legacy of his mentor, John T. Reeves, MD, a legendary figure
in pulmonary hypertension at the University of Colorado
Health Sciences Center, who died in a bicycle accident last
year. Soon after joining the faculty at the University of
Colorado in 1979, Dr Groves was managing the catheterization
laboratory when he began doing research influenced
by Dr Reeves. “It was obviously becoming critical to have
someone involved in the hemodynamics of pulmonary
hypertension, to get deeply involved,” recalled Dr Groves.
“Jack Reeves took me under his wing and was my mentor
for many years. We had a very rich collaboration and he
really pulled me into the pulmonary hypertension world,
and it felt right because my home was the catheterization
lab at that time and still is.”
Remembering the bench research of the early 1980s,
he notes: “A lot of the studies we did were considered very
risky and sort of on the fringe of what perhaps was appropriate.
Some of my colleagues were openly critical of some
of these studies because they feared that the likelihood of
success would be too small to warrant the risk. In fact, 15
years later we got prostacyclin approved by the FDA, and
now it is influencing the management of pulmonary hypertension
in a pretty broad spectrum.”
Describing himself as “a purebred catheterization guy
from the start,” Dr Groves explained how he began relating
the work he was doing in the catheterization lab to pulmonary
hypertension. “A lot of the studies that had been
done were noninvasive and trying to use estimations of pulmonary
pressure by various means, including echocardiography.
As one who emphasized hemodynamics, that did not
satisfy me, and I thought we could do the studies invasively
and do them safely, even though there was a track record
in the literature that some of these patients had sudden
death in the catheterization procedures. That’s how I
brought the two together and it has worked out very well for
20 years.”
Operation Everest: A Landmark Study
in Pulmonary Hypertension
Dr Groves said he considers himself “a bridge” between the
pulmonologist and the cardiologist, applying lessons from
interventional cardiology to the management of pulmonary
hypertension. One of his most exciting research projects
was the “Operation Everest” expedition in which an
Everest-like environment was simulated in a hyperbaric
chamber in Massachusetts at the US Army Research
Institute. The concept was to take normal volunteers into
the hypoxic chamber for 40 days and nights and pattern
their exposure to hypoxia and altitude.
“We were going to use echocardiographic estimation of
the pulmonary hypertension they developed. I convinced
them that instead of doing noninvasive assessments we
should do serial cardiac catheterizations,” he added. “I
agreed to do all the catheterizations on all of the subjects,
and I commuted back and forth from Denver to Natick,
Massachusetts, during those 40 days to do the serial studies
that led to the hemodynamic definition of pulmonary
hypertension. It was a fantastic experience with these
numerous scientists who put it all together.”
Returning to His Roots, Interventional Cardiology
Today Dr Groves has returned to his roots, so to speak, interventional
cardiology, having turned over the direction of the
continued development of the pulmonary hypertension center
and clinic to his protégé, David B. Badesch, MD, whom
he trained. “I continue to do the hemodynamic work to
make sure I train other cardiologists to do what I have been
doing for him.” For Dr Badesch, the arrangement has been
mutually beneficial, and he refers to Dr Groves as “a fantastic
educator, always willing to share time and expertise
as one of the true pioneers 20 years ago. He is one of the
true experts on obtaining right heart hemodynamics and
has been my mentor.”
Looking toward new horizons in pulmonary hypertension,
Dr Groves sees the trend toward trying to monitor the
ongoing pulmonary pressure as the next focus. “The reason
pulmonary hypertension was neglected for so long was that
you couldn’t put your pulmonary artery in a cuff and go into
the grocery store and measure what it was. Systemic hypertension
has always been so easy to monitor and pulmonary
hypertension has been so difficult. But now we have the
invasive-type devices that are being developed to monitor
chronic pulmonary artery pressure to see what happens over
the full course of daily living. I’m expecting that there will
be more of an emphasis on that in the next decade.”
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