Worldwide, the decrease in standard stress testing is offset by greater use of advanced cardiac imaging modalities. In multivariable regression, only lower-income status and physicians' psychological stress were significant in predicting recovery of cardiac testing.Ĭardiac diagnostic testing has yet to recover to prepandemic levels in lower-income countries. Pandemic-related psychological stress was estimated to have affected nearly 40% of staff, impacting patient care at 78% of sites. Although stress testing was used 12% less frequently in 2021 than in 2019, coronary computed tomographic angiography was used 14% more, a trend also seen for other advanced cardiac imaging modalities (positron emission tomography and magnetic resonance 22%-25% increases). Worldwide reduction in cardiac procedure volumes of 64% from March 2019 to April 2020 recovered by April 2021 in high- and upper middle-income countries (recovery rates of 108% and 99%) but remained depressed in lower middle- and low-income countries (46% and 30% recovery). Surveys were submitted from 669 centers in 107 countries. Multivariable regression was used to determine factors associated with procedure volume recovery. The International Atomic Energy Agency conducted a worldwide survey assessing alterations from baseline in cardiovascular diagnostic care at the pandemic's onset and 1 year later. The aim of this study was to determine the impact of the pandemic on cardiac testing practices, volumes and types of diagnostic services, and perceived psychological stress to health care providers worldwide. The extent to which health care systems have adapted to the COVID-19 pandemic to provide necessary cardiac diagnostic services is unknown.
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