NEWS
1. Kawasaki Medical University ① (Takeshi Nishi & Shiro Uemura)
Progression of coronary artery lesions and their relationship with microcirculatory
2. Kawasaki Medical University ② (Takeshi Nishi & Shiro Uemura)
A study on the relationship between diabetes mellitus, coronary microcirculatory disorders, coronary spasm diagnosis, and clinical outcomes
3. Chiba University (Yuichi Saito & Yoshio Kobayashi)
The impact of differences in diagnostic criteria for coronary spasm provocation tests on clinical features and prognosis
4. Kumamoto University (Masanobu Ishii and Kenichi Tsujita)
Effects of per- and polyfluoroalkyl substances (PFAS), an organic fluorinated compound, on coronary vasospasm and coronary microcirculatory disorders
5. Tsuchiura Cooperative Hospital ① ( Yoshihisa Kanaji and Tsunekazu Kakuta)
Classification of CMD phenotypes in patients with ANOCA
6. Tsuchiura Cooperative Hospital ② (Kodai Sayama and Tsunekazu Kakuta)
A study on the relationship between invasive measurements of coronary flow reserve (CFR) and clinical features and prognosis of patients with chest pain (ANOCA) without significant stenosis in the epicardial coronary arteries, focusing on the endotypes of ANOCA
7. Tsuchiura Cooperative Hospital③ (Yasuo Hosokawa / Tsunekazu Kakuta)
Distribution of Coronary Microvascular Dysfunction in ANOCA Patients: Clinical Characteristics According to Affected Vessels (LAD, RCA, Both)
8. Tsuchiura Cooperative Hospital④ (Hiroki Ueno / Tsunekazu Kakuta)
A Study on the Clinical Features, Symptoms, and Prognostic Factors of Patients Diagnosed with Non-Cardiac Chest Pain via Invasive Diagnostic Methods
9. Tsuchiura Cooperative Hospital⑤ (Takahiro Watanabe / Tsunekazu Kakuta)
The Relationship Between VSA or MVS and Endogenous or Classical Type CMD
10. Kurume University (Ryohei Mitsutake and Yoshihiro Fukumoto)
Exploratory study on the optimal combination of pharmacotherapy for CMD
11. Mie University① (Akihiro Takasaki and Kaoru Doi)
The relationship between the presence or absence of SMuRFs and coronary microvascular dysfunction, and its impact on prognosis
12. Miyazaki University (Hiroki Tanaka and Koichi Kaimoto)
A study on the relationship between obesity and coronary microcirculatory dysfunction
13. Tohoku University (Jun Takahashi and Satoshi Yasuda)
Investigation of the involvement of chronic inflammation in coronary artery functional abnormalities in INOCA patients
＊14. Tsuchiura Cooperative Hospital⑥ (Eisuke Usui & Tsunekazu Kakuta)
Comparison of clinical features, phenotypes, and the frequency of VSA/MVS comorbidities based on the history of PCI in ANOCA patients
＊15. Mie University② (Akihiro Takasaki &anp; Kaoru Doi)
Association between coronary microcirculatory dysfunction and clinical prognosis in dialysis patients
＊16. Mie University③ (Akihiro Takasaki & Kaoru Doi)
A study on the prevalence and prognosis of connective tissue diseases (CTD), inflammatory bowel disease (IBD), and vasculitis in J-CMD registry patients, with a focus on INOCA endotypes
On October 1, 2025, the J-CMD Study Group has initiated an international joint research project called "Inter-CMD Study" to advance understanding and treatment of Coronary Microvascular Dysfunction (CMD), which is related to coronary blood flow.
As shown on the map, this study involves medical institutions from across Japan, including university hospitals and specialized cardiovascular facilities, as well as leading medical institutions from the United States, Canada, the United Kingdom, Italy, Spain, Germany, Australia, and Singapore. A total of 25 facilities will collaborate to collect patient case data and conduct research.
The Inter-CMD Study aims to comprehensively record and analyze patient characteristics, test results, and treatment progress to deepen our understanding of the disease mechanisms. The findings are expected to lead to more accurate diagnostic methods and the development of new treatments, ultimately improving the quality of life for patients with CMD.
We look forward to your anticipation and support for this collaborative effort among experts worldwide.
Since July 1 of this year, 13 facilities have been added, bringing the total number of facilities across the country to 280.
During the operational meeting, the participation of Kyushu University and Tokyo Medical Center was officially approved. Additionally, Dr. Tsunekazu Kakuta (Tsuchiura Cooperative Hospital) and Dr. Kenichi Tsujita (Kumamoto University) were elected as vice representatives. Discussions also covered authorship for future publications. Furthermore, topics such as the effective utilization of registration data exceeding 1,200 cases, proteomics research, and international collaborative research with COVADIS (Inter-CMD research) were discussed.
Please find the poster and abstract attached (PDF). You can join via the URL below. We look forward to many participants.
Part 2: URL for participating in the research meeting
https://us06web.zoom.us/j/86233312246?pwd=LDe6lG7QC6ArswJO3ALXt21lylFyKq.1
Since April 1 of this year, 20 new facilities have been added, bringing the total to 267 across the country.
Since January 1 of this year, 11 new facilities have been added, bringing the total to 247 across the country.
Additionally, the Tokyo Jikei Medical University Katsushika Medical Center was approved as the 31st facility and has joined the program.
At the operational meeting, the participation of Tokyo Jikei Medical University Katsushika Medical Center was officially approved.
Discussions also covered the effective utilization of registration data exceeding 1,000 cases and additional registration items.
Furthermore, the policy for international joint research with COVADIS was confirmed.
During the research meeting, active exchanges took place regarding seven new joint research projects being conducted for the first time.
Please find the poster and abstract attached (PDF).
Join us via the URL below. We look forward to the participation of many of you.
Part 2: URL for participating in the research meeting
https://us06web.zoom.us/j/83630710325?pwd=zO60t6PbwyF1IGeaAZ29LktPtQRmkM.1
Participants will include 12 facilities from J-CMD and 9 facilities from 6 countries within the COVADIS group. The study is planned to span five years and will involve an international collaborative registration study related to CMD.
1. Participating facilities on the J-CMD side (in no particular order):
Principal Investigator:
Hiroaki Shimokawa (Tohoku University / International University of Health and Welfare)
２. Participating Institutions on the COVADIS Side
（HP：https://covadis.online/）
Since October 1st of last year, 27 new facilities have been added. Notably, new implementations have been introduced in Aomori Prefecture and Saga Prefecture.
This milestone was achieved in approximately 1 year and 10 months since the registration of cases began in March 2023.
We sincerely thank all participating facilities for their cooperation.
At J-CMD, we aim to continue conducting various collaborative studies and strive to reach the next milestone of 2,000 registered cases.
This time, seven projects were selected for the initial joint research. Moving forward, we will continue to add more collaborative studies to accumulate evidence of CMD in the Japanese population.
Since July 1 of this year, 24 new facilities have been added.
Please see the program for that day here.
The program was divided into three parts: Part 1 covered the status of CMD research in various countries, Part 2 discussed the diverse clinical phenotypes of CMD, and Part 3 focused on the Endotypes of CMD. There was active discussion and Q&A.
The conference was also simultaneously streamed online for participants from different countries.
Venue Scenes
Presentation Scenes
Group Photo
The importance of coronary microvascular dysfunction in heart disease is increasingly recognized.
According to the "Clinical Practice Guidelines for Chronic Coronary Syndromes (CCS)" issued by the European Society of Cardiology on August 30, 2024, functional tests for coronary microvascular dysfunction are recommended with the highest priority (Class I).
It is expected that CMD testing will become more widely adopted in our country in the future.
Please refer to this website for facilities that perform CMD testing in our country.
During the operational meeting, the establishment of a Steering Committee was approved to promote academic activities related to the research meetings (see below, without honorifics).
Chairperson: Hiroaki Shimokawa (International University of Health and Welfare / Tohoku University)
Vice Chairpersons: Tsunekazu Kakuta (Tsuchiura Kyodo Hospital)Kenichi Tsujita (Kumamoto University)
Members (in alphabetical order):
Secretary General: Morihiko Takeda (International University of Health and Welfare Hospital)
Additionally, six research presentations were made, and active discussions took place.
Please find attached the poster and abstract collection (PDF).
Please find the poster and abstract collection attached (PDF). You can join via the URL below. We look forward to the participation of many of you.
Part 2: URL for participating in the research meeting
https://us06web.zoom.us/j/84580487870?pwd=tOy2TIfepjzsalbU7Dkp0dkiztUkgB.1
Since April 1 of this year, 24 new facilities have been added.
Since January 5 of this year, 12 new facilities have been added.
Additionally, CMD testing is now available in Niigata Prefecture.
Please find the poster and abstract collection attached (PDF).
This time, participation from Oumi Medical Center (Shiga Prefecture) was newly approved.
Facility representative:Dr. Atsuyuki Wada
Test coordinator: Dr. Takefumi Kishimori
Additionally, Dr. Takahiko Kiyooka (Ikegami General Hospital) was elected as a facilitator.
You can view the records of the research meeting at this URL.
This milestone was reached approximately one year after starting case registration.
We sincerely thank all participating facilities for their cooperation.
Our goal is to reach the next milestone of 1,000 registered cases.
Please find the poster and abstract collection attached (PDF).You can join via the URL below. We look forward to the participation of many of you.
Part 2: URL for participating in the research meeting
https://us06web.zoom.us/j/89459277550?pwd=GF9aR2Ew50jG3Bxzui6rsv2-sy6S4BpV.TquOBDEk4-tbPsn5
Since October 1st last year, 20 new facilities have been added. Additionally, CMD testing is now available in Toyama Prefecture and Tokushima Prefecture.
During the program, microvascular angina was presented as a "hidden angina" that is often overlooked, and the J-CMD website, which introduces facilities nationwide conducting tests for coronary microcirculatory disorders, was shown. On the day of the broadcast, access to the J-CMD website reached 23,534 visits, demonstrating high interest in microvascular angina.
The lecture was organized by Professor Jang of the Department of Cardiology at the same hospital, and the lecture title was as follows:
[Lecture Title]
Shimokawa H. Increasing importance of microvascular dysfunction in cardiovascular medicine: From the heart to the brain.
During the lecture, Professor Shimokawa introduced the growing significance of microcirculatory disorders in an aging society, particularly their increasing impact on the heart (microvascular angina, heart failure, etc.) and the brain (dementia, etc.), as well as the fact that effective and safe treatments have yet to be established. He also discussed the development of advanced treatments such as Low-Intensity Pulsed Ultrasound (LIPUS) therapy. The lecture was broadcast online to three related hospitals in addition to Massachusetts General Hospital, and an active question-and-answer session took place.
Scene from the lecture (introducing J-CMD)
Together with Professor Jang
In 1846, the world's first surgery under ether anesthesia was performed
at the “Ether Dome (Auditorium)” with Japanese exchange students from Jang's lab.
Since July 1, an additional 14 facilities have been added.
The following six facilities are included.
In total, there are now 28 facilities participating in J-CMD.
| Facility Responsible Person | Practical Contact Person | |
|---|---|---|
| Teikyo University) | Professor Ken Uetsuma* |
Dr. Yutaka Yamamoto |
| National Cerebral and Cardiovascular Center) | Vice Director Teruo Noguchi |
Dr. Yasuhiro Asami |
| Tokyo Medical and Dental University) | Professor Tetsuro Sasano |
Dr. Taishi Yonezu |
| Osaka University) | Professor Yasushi Sakata |
Dr. Yohei Sotai |
| Showa University Fujigaoka Hospital) | Professor Hiroshi Suzuki |
Dr. Yoshiyoshi Mori |
| Tokyo Women's Medical University) | Professor Junichi Yamaguchi |
Dr. Hiroyuki Arashi |
*New coordinator
It was conducted in a hybrid format. Please see the program for the day here.
Professor Shimokawa gave a presentation on the international registry of CMD conducted by COVADIS.
This time, participation was approved for the following six new facilities:
Additionally, it was reported that each month, 60 to 70 cases of CMD tests are registered from participating facilities nationwide.
Please find the attached poster and abstract collection (PDF).You can join via the URL below.We look forward to many participants.
Part 2: Research Meeting Participation URL
https://zoom.us/j/92589388487
New testing facilities have been added in Yamanashi Prefecture and Nara Prefecture.
The title of Professor Shimokawa's lecture is as follows:
Shimokawa H. Endothelial and smooth muscle cell dysfunction and vasoreactivity
You can view the program here:
Coronary_Artery_Dosease_and_Myocardial_Ischemia_Syndromes_2023
Additionally, all lecture slides are available for free download at the following link:
https://www.en.fondazione-menarini.it
The six approved facilities are as follows (refer to "CMD examination facilities" in the section on testing methods and treatments):
New participating facilities:
• Aichi Medical University (Professor Tetsuya Amano)
• Defense Medical University (Professor Ken Adachi)
• Mie University (Professor Kaoru Dohi)
• Ehime University (Professor Osamu Yamaguchi)
• Gifu Prefectural Medical Center (Director Toshiyuki Noda)
• Ikegami General Hospital (Director Takahiko Kiyooka)
New Coordinators:
• Professor Ken Kamizuma (Teikyo University)
• Professor Tetsuya Amano (Aichi Medical University)
New Participating Facilities:
• Teikyo University (Professor Ken Kamizuma)
• Aichi Medical University (Professor Tetsuya Amano)
• Defense Medical University (Professor Ken Adachi)
• Mie University (Professor Kaoru Dohi)
• Ehime University (Professor Osamu Yamaguchi)
• Gifu Prefectural Medical Center (Director Toshiyuki Noda)
• Ikegami General Hospital (Director Takahiko Kiyooka)
The details of the Fireside Seminar are as follows (you can view the poster here):
Fireside Seminar 7
Theme: Increasing Importance of Coronary Microcirculatory Disorders
Date and Time: Friday, March 10, 2023, 17:50–18:40
Venue: Room 13
Chairpersons: Hiroka Yokoi (Fukuoka Sanno Hospital),
Hiroaki Shimokawa (International University of Health and Welfare)
Speaker 1: Tsunekazu Kakuta (Tsuchiura Cooperative Hospital)
"Significance of Coronary Microcirculatory Disorders in Myocardial Ischemia"
Speaker 2: Hiroaki Shimokawa (International University of Health and Welfare)
"The Growing Importance of Coronary Microcirculatory Disorders and the Establishment of J-CMD"
It introduces the background and significance of establishing J-CMD, research methods, and activity goals (Permission for reprint has been obtained.)
You can view the January issue of the INOCA Newsletter here. (Permission for reprint has been obtained.)
The newsletter introduces Professor Shimokawa, who has been a member of the Medical Advisory Board since last year, and J-CMD.
The details of the paper are as follows:
Suda A, Takahashi J, Schwidder M, Ong P, Ang D, Berry C, Camici PG, Crea F, Kaski JC, Pepine C, Rimoldi O, Sechtem U, Yasuda S, Beltrame JF, Merz NBC, Shimokawa H. Prognostic association of plasma NT-proBNP levels in patients with microvascular angina -A report from the international cohort study by COVADIS- IJC Heart and Vasculature. 2022, 43, 101139.
In this sub-analysis, it was revealed that serum NT-proBNP levels serve as a new prognostic biomarker for microvascular angina.
INOCA International is a patient-centered organization based in the United Kingdom and is a member of the World Heart Federation. They actively engage in awareness activities, including regularly publishing a newsletter. As a member of COVADIS, an interview video with Professor Shimokawa has been made available.
It appears that interest in microvascular angina is increasing among the general public.
▼ Weekly Post Issue 32 (published October 17) "Ishin Denshin" Episode 738
"Persistent chest pain that doesn't go away even after treatment is caused by microvascular angina" (Permission for reprint obtained)
▼ Weekly Post Issue 33 (published October 24) "Ishin Denshin" Episode 739
"Hope for new diagnostic methods and treatments to improve microvascular angina"(Permission for reprint obtained)
COVADIS was established in 2012 and celebrated its 10th anniversary this year. It was the first in-person conference in three years, providing an opportunity to reconnect with colleagues and exchange the latest knowledge on coronary artery functional abnormalities （program）.
The presentation covered a sub-analysis of a prospective registry study on microvascular angina conducted by the international research organization COVADIS, demonstrating that NT-proBNP levels have prognostic predictive value（poster presentation).
The kickoff meeting was conducted in two parts. In Part 1, the coordinators from 16 participating institutions confirmed the future direction of activities related to this research group. It was decided to conduct a prospective, nationwide multi-center registry study on CMD cases. In Part 2, a lecture session was held, featuring three speakers: Prof. Hiroaki Shimokawa, the principal organizer; Dr. Tsunekazu Kakuta, Vice Director of Tsuchiura Kyodo Hospital; and Prof. Kenichi Tsujita from Kumamoto University. Approximately 200 participants from across the country attended, and active Q&A sessions took place.
© 2022 日本冠微小循環障害研究会
