My First Step Into the Pulmonary Circulation World

The establishment of the pulmonary hypertension center in Giessen, initiated in the late 1980s and further developed over the following decades by the founding team of Friedrich Grimminger, Ardeschir Ghofrani, Ralph Schermuly, and myself, has its roots in research projects on acute lung injury, ARDS. Employing the multiple gas elimination technique (MIGET), we observed severe ventilation/perfusion (V/Q) mismatch with high shunt in the ARDS lungs, accompanied by elevated pulmonary artery pressure levels.

“Why is there more variation in the females? Could it be due to their estrous cycle?” This was the question my co-mentor, Dr. Irina Petrache, posed when I shared the first data I generated as a first-year research fellow. It was 2007, and was in the lab of cardiothoracic surgeon Dr. Dan Meldrum at Indiana University. 

It was a Sunday morning. That was the only time Drs. Pat Daily or Walt Dembitsky could review cases before they operated on Monday. It was 1986, and I was a pulmonary fellow, so my presence at this meeting with Dr. Kenneth Moser (1929–1997) (Figure 1) was as an observer, not a participant. 

In 1988, I had spent over 2 years at the Physiological Institute, working on the competition between skin- and muscle blood flow for cardiac output in man during exercise, when I started my residency in Internal Medicine. There I met Werner Seeger, who was a consultant and was directing the Intensive Care Unit at that time. He enrolled me in his research group, which focused on acute respiratory stress syndrome (ARDS), a condition characterised by a ventilation-perfusion mismatch that results in competition for blood flow between well- and poorly ventilated lung areas, a topic I had previously explored in my scientific work.