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SummaryPulmonary hypertension (PH) induced by pulmonary tumor thrombotic microangiopathy (PTTM) can be fatal because its rapid progression confounds diagnosis, and it is difficult to control with therapy. Here we describe a woman with symptomatic PTTM-PH accompanying gastric cancer that was suspected from perfusion scintigraphy. PTTM-PH was diagnosed by gastroesophageal endoscopy and lung biopsy after partial control of PH using the platelet-derived growth factor (PDGF) receptor (PDGFR) tyrosine kinase inhibitor, imatinib. Treatment with sildenafil and ambrisentan further decreased PH, and she underwent total gastrectomy followed by adjuvant TS-1 chemotherapy. PH did not recur before her death from metastasis. Postmortem histopathology showed recanalized pulmonary arteries where the embolized cancer masses disappeared. PDGF-A, -B, and PDGFR-α, β expression was detected in cancer cells and proliferating pulmonary vascular endothelial cells. Thus, PTTM-PH was successfully controlled using a combination of imatinib, drugs to treat pulmonary arterial hypertension, and cancer management. (Int Heart J 2015; 56: 245-248)

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2186KATO NP et al. Circulation JournalOfficial Journal of the Japanese Circulation Society http://www. j-circ.or.jpMeanwhile, there are no studies evaluating the difference in QOL between implantable and extracorporeal LVAD patients. The 2 types of LVADs provide similar results in terms of systemic circulation assist and cardiac unloading effect, but the effect on patients' QOL may differ.It is important to understand the factors associated with patients' QOL in order to outline management strategies for LVAD patients that do not only focus on objective goals, but also on the patients' perceptions. Prior studies have shown limited associations between psychological distress and QOL, 1,7 suggesting that factors other than psychological problems may be important in determining QOL after LVAD implantation.The purpose of the present study was (1) to evaluate the effect of an having an implantable LVAD on patients' QOL, eft ventricular assist device (LVAD) therapy is expected to be increasingly indicated as a bridge to transplant or/and destination therapy. However, studies focusing on the effect of LVAD therapy on patients' quality of life (QOL) are limited. 1-3 In Japan, the number of LVAD patients has been increasing since implantation became covered by health insurance in 2011. It is important to know the effect of LVAD therapy from the patients' perspective.Comparison of the QOL of patients with an implantable LVAD and those in different stages of heart failure (HF) might help healthcare professionals to understand how much improvement in QOL can be expected from implantable LVADs. Several studies have shown that implantable LVAD patients have a better QOL than heart transplantation (HTx) patients. Minoru Ono, MD, PhD; Tiny Jaarsma, PhD; Koichiro Kinugawa, MD, PhDBackground: Improving quality of life (QOL) has become an important goal in left ventricular assist device (LVAD) therapy. We aimed (1) to assess the effect of an implantable LVAD on patients' QOL, (2) to compare LVAD patients' QOL to that of patients in different stages of heart failure (HF), and (3) to identify factors associated with patients' QOL.