Global CMD Registry Research Helps Understand Chest Pain Before Tragedy Strikes

Global CMD Registry Research Helps Understand Chest Pain Before Tragedy Strikes.

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MedStar Health Research Institute is leading a global effort to understand better coronary microvascular dysfunction with a worldwide patient data registry.


Through a first-of-its-kind free global registry and advanced testing technology, MedStar Health Research Institute is revolutionizing the medical understanding of coronary microvascular dysfunction (CMD)—a diagnosis given when other causes of chest pain have been ruled out. 

The Coroventis CoroFlow Cardiovascular system is an advanced diagnostic technology that allows us to diagnose CMD more definitively. Pairing this not-yet-widely-available technology with our CMD registry (CMDR), which has been online for close to 1 year, is already changing our understanding of this tricky condition.

CMD is a non-obstructive disease that causes malfunction of the small blood vessels that supply the heart. Decreased blood flow can cause symptoms similar to heart attack, such as chest pain, shortness of breath, and fatigue. Over time, it can increase the risk of major cardiovascular adverse events.

Historically, CMD has been difficult to diagnose. While standard tests like coronary angiography look for blockages in the heart’s large arteries, 50% of patients with chest pain do not have significant blockages  as defined by <50% narrowing.

Studies estimate that 4 million people in the U.S. might have CMD, and about 70% are women—many of whom are dismissed from the emergency room with a diagnosis of heartburn or anxiety because their large arteries are clear. Our research will hopefully help clinicians identify more patients with CMD before tragedy strikes.

Related reading: Melanie’s Story: How Determination and Advanced Technology Found the Cause of Her Heart Attack.

Why build a registry for CMD?

With the CoroFlow system, confidently diagnosing CMD and providing timely treatment is now possible. The rapid expansion of our knowledge offers an opportunity to collaborate with providers around the world to learn more about:

  • Different types of CMD
  • How do these types present in patients
  • Other types of evaluation and noninvasive testing
  • Prospective data, including how patients treated for CMD fare in the long run

We created the CMDR, a collaborative global registry funded by MHRI, to collect encrypted data from patients who are tested for CMD, including:

  • Baseline characteristics
  • Comorbidities
  • Medications
  • Chest pain severity
  • Noninvasive cardiovascular testing
  • Coronary anatomy based on angiography
  • Physiologic measurements
  • Postprocedural outcomes

The registry currently contains data from 253 MedStar Washington Hospital Center and MedStar Southern Maryland Hospital Center patients. Seven institutions are in the process of joining the registry, and another 21 are interested, including hospitals from many U.S. states, Italy, Hungary, Egypt, and Brazil.

Preliminary CMDR findings.

Our team’s first paper based on CMDR data was published in summer 2023 in the American Journal of Cardiology. Early data shed light on characteristics of CMD, including:

  • About one-third of patients suspected of having CMD were confirmed to have the condition after testing with the CoroFlow system.
  • The CoroFlow system is safe. There were no testing complications among patients in the CMDR. 
  • CMD-positive patients tend to have a lower body mass index than CMD-negative patients.

Ten more manuscripts in various stages of publishing investigate the diagnosis process, mental health impacts of CMD, potential associated factors such as chemotherapy and excess fat, and relevance of EKG abnormalities. 

Thanks to our research and advocacy, the U.S. Centers for Disease Control and Prevention recently assigned an ICD-10 code to CMD. These codes establish medical necessity for payment of healthcare services so insurers can cover treatment, which will also lead to more data to support the need for more research. 

For too long, we’ve told patients what their chest pain doesn’t mean. Now, we can provide an accurate diagnosis, and we’re leading the world in creating a new understanding about CMD to benefit future generations.

Are you or a loved one experiencing unexplained chest pain?

Our cardiology experts are here to help. Call 202-877-3627.

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