DEMÊNCIA COM CORPOS DE LEWY: UMA ANÁLISE DA PATOLOGIA, DIAGNÓSTICO E INTERVENÇÕES TERAPÊUTICAS POR MEIO DE UMA REVISÃO BIBLIOGRÁFICA DE LITERATURA

Introduction: Dementia with Lewy bodies (DCL) is the second most common cause of neurodegenerative dementia, presenting challenges in diagnosis and clinical management due to its symptomatic complexity. Objective: This article aims to provide a comprehensive analysis of the pathology, diagnosis and therapeutic interventions in DCL. Methods: This is a bibliographic review, using articles present in the following databases: PubMed, Scopus and Web of Science. Original articles and systematic reviews in English and Portuguese published between 2015 and 2024 were included, which addressed pathology, diagnosis and therapeutic interventions in DLB. After analysis, 15 articles were selected to prepare this bibliographic review. Discussion: The clinical features of CLD were addressed, including distinctive symptoms and challenges in differential diagnosis. The pathogenesis involves mechanisms such as the formation of alpha-synuclein aggregates and synaptic dysfunction. Current therapeutic options are mainly aimed at relieving symptoms, but there are no curative treatments. Conclusion: DCL represents a challenging neurodegenerative condition, requiring early diagnosis and appropriate management to improve patients' quality of life. Continued research into biomarkers and targeted therapies is essential to advance the knowledge and treatment of DCL. Awareness and a multidisciplinary approach are key to optimizing clinical outcomes.Introducción: La demencia con cuerpos de Lewy (DCL) es la segunda causa más común de demencia neurodegenerativa, presentando retos en el diagnóstico y manejo clínico debido a su complejidad sintomática. Objetivo: Este artículo pretende ofrecer un análisis exhaustivo de la patología, el diagnóstico y las intervenciones terapéuticas en la DCL. Métodos: Se trata de una revisión bibliográfica, utilizando artículos presentes en las siguientes bases de datos: PubMed, Scopus y Web of Science. Se incluyeron artículos originales y revisiones sistemáticas en inglés y portugués publicados entre 2015 y 2024, que abordaron patología, diagnóstico e intervenciones terapéuticas en DLB, luego del análisis se seleccionaron 15 artículos para elaborar esta revisión bibliográfica. Discusión: Se abordaron las características clínicas de la EPC, incluidos los síntomas distintivos y los retos en el diagnóstico diferencial. La patogénesis implica mecanismos como la formación de agregados de alfa-sinucleína y la disfunción sináptica. Las opciones terapéuticas actuales se dirigen principalmente a aliviar los síntomas, pero no existen tratamientos curativos. Conclusión: La DCL representa una enfermedad neurodegenerativa difícil, que requiere un diagnóstico precoz y un tratamiento adecuado para mejorar la calidad de vida de los pacientes. La investigación continua de biomarcadores y terapias dirigidas es esencial para avanzar en el conocimiento y tratamiento de la DCL. La concienciación y un enfoque multidisciplinar son fundamentales para optimizar los resultados clínicos.Introdução: A demência com corpos de Lewy (DCL) é a segunda causa mais comum de demência neurodegenerativa, apresentando desafios no diagnóstico e manejo clínico devido à sua complexidade sintomática. Objetivo: Este artigo visa fornecer uma análise abrangente da patologia, diagnóstico e intervenções terapêuticas na DCL. Métodos: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e Web of Science. Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2015 e 2024, que abordassem sobre patologia, diagnóstico e intervenções terapêuticas na DCL.. Após a análise, foram selecionados 15 artigos para a confecção dessa revisão bibliográfica. Discussão: Foram abordadas as características clínicas da DCL, incluindo sintomas distintivos e desafios no diagnóstico diferencial. A patogênese envolve mecanismos como a formação de agregados de alfa-sinucleína e disfunção sináptica. As opções terapêuticas atuais visam principalmente aliviar os sintomas, mas não há tratamentos curativos. Conclusão: A DCL representa uma condição neurodegenerativa desafiadora, exigindo diagnóstico precoce e manejo adequado para melhorar a qualidade de vida dos pacientes. A pesquisa contínua sobre biomarcadores e terapias direcionadas é essencial para avançar no conhecimento e tratamento da DCL. A conscientização e abordagem multidisciplinar são fundamentais para otimizar os resultados clínicos.Introdução: A demência com corpos de Lewy (DCL) é a segunda causa mais comum de demência neurodegenerativa, apresentando desafios no diagnóstico e manejo clínico devido à sua complexidade sintomática. Objetivo: Este artigo visa fornecer uma análise abrangente da patologia, diagnóstico e intervenções terapêuticas na DCL. Métodos: Trata-se de uma revisão bibliográfica, utilizando artigos presentes nas seguintes bases de dados: PubMed, Scopus e Web of Science. Foram incluídos artigos originais e revisões sistemáticas em inglês e português publicadas entre 2015 e 2024, que abordassem sobre patologia, diagnóstico e intervenções terapêuticas na DCL.. Após a análise, foram selecionados 15 artigos para a confecção dessa revisão bibliográfica. Discussão: Foram abordadas as características clínicas da DCL, incluindo sintomas distintivos e desafios no diagnóstico diferencial. A patogênese envolve mecanismos como a formação de agregados de alfa-sinucleína e disfunção sináptica. As opções terapêuticas atuais visam principalmente aliviar os sintomas, mas não há tratamentos curativos. Conclusão: A DCL representa uma condição neurodegenerativa desafiadora, exigindo diagnóstico precoce e manejo adequado para melhorar a qualidade de vida dos pacientes. A pesquisa contínua sobre biomarcadores e terapias direcionadas é essencial para avançar no conhecimento e tratamento da DCL. A conscientização e abordagem multidisciplinar são fundamentais para otimizar os resultados clínicos

OS IMPACTOS DA DESINFORMAÇÃO SOBRE A TOXOPLASMOSE NA GRAVIDEZ: FORMAS DE TRANSMISSÃO, PREVENÇÃO E TRATAMENTO

Toxoplasma gondii (T. gondii) is an obligatory intracellular parasite whose life cycle involves cats as primary hosts and other mammals, including humans, as intermediate hosts. Transmission occurs mainly through the ingestion of contaminated food or contact with infected cat feces. The prevalence of toxoplasmosis varies globally, being more common in tropical regions and correlated with socioeconomic conditions. It is estimated that up to 30% of the world's population has been exposed to the parasite, and studies in Brazil indicate a significant prevalence among pregnant women. T. gondii infection during pregnancy can result in complications for the fetus, such as retinal disease, with consequences that may persist into adulthood. Diagnosis and treatment of congenital toxoplasmosis are essential to mitigate these adverse effects. This study conducted an integrative literature review, using the PICo strategy to investigate the impacts of misinformation on toxoplasmosis in pregnant women. The research was conducted in databases such as MEDLINE, LILACS, and Nursing Database, resulting in a selection of 13 articles for analysis. The results highlight the importance of T. gondii serology during prenatal care and regular monitoring of pregnant women to detect possible acute infections. Treatment, when necessary, should be promptly initiated to reduce vertical transmission and the severity of congenital disease. Furthermore, the lack of adequate preventive guidance for susceptible pregnant women underscores the need for capacity building of healthcare professionals to provide relevant hygienic and dietary information. In conclusion, toxoplasmosis during pregnancy represents a significant public health concern, requiring effective prevention measures and access to proper healthcare. Public awareness and investment in ongoing research are essential to reduce the incidence of congenital toxoplasmosis and ensure better outcomes for mothers and babies. Keywords: Toxoplasma gondii, toxoplasmosis, pregnancy, vertical transmission, prevention, treatment, maternal health.Toxoplasma gondii (T. gondii) es un parásito intracelular obligado cuyo ciclo de vida implica a los gatos como huéspedes primarios y a otros mamíferos, incluidos los humanos, como huéspedes intermedios. La transmisión ocurre principalmente a través de la ingestión de alimentos contaminados o el contacto con heces de gatos infectados. La prevalencia de la toxoplasmosis varía a nivel mundial, siendo más común en regiones tropicales y correlacionada con condiciones socioeconómicas. Se estima que hasta el 30% de la población mundial ha estado expuesta al parásito, y estudios en Brasil indican una prevalencia significativa entre mujeres embarazadas. La infección por T. gondii durante el embarazo puede provocar complicaciones para el feto, como enfermedad retiniana, con consecuencias que pueden persistir hasta la edad adulta. El diagnóstico y tratamiento de la toxoplasmosis congénita son fundamentales para mitigar estos efectos adversos. Este estudio realizó una revisión bibliográfica integrativa, utilizando la estrategia PICo para investigar los impactos de la desinformación sobre la toxoplasmosis en mujeres embarazadas. La investigación se llevó a cabo en bases de datos como MEDLINE, LILACS y la Base de Datos de Enfermería, lo que resultó en una selección de 13 artículos para su análisis. Los resultados destacan la importancia de la serología para T. gondii durante la atención prenatal y el monitoreo regular de las mujeres embarazadas para detectar posibles infecciones agudas. El tratamiento, cuando es necesario, debe iniciarse rápidamente para reducir la transmisión vertical y la gravedad de la enfermedad congénita. Además, la falta de orientación preventiva adecuada para mujeres embarazadas susceptibles subraya la necesidad de capacitar a los profesionales de la salud para proporcionar información relevante sobre higiene y dieta. En conclusión, la toxoplasmosis durante el embarazo representa una preocupación importante para la salud pública, que requiere medidas de prevención efectivas y acceso a atención médica adecuada. La concienciación pública y la inversión en investigación continua son fundamentales para reducir la incidencia de toxoplasmosis congénita y garantizar mejores resultados para las madres y los bebés.O Toxoplasma gondii (T. gondii) é um parasita intracelular obrigatório cujo ciclo de vida envolve gatos como hospedeiros primários e outros mamíferos, incluindo humanos, como hospedeiros intermediários. A transmissão ocorre principalmente pela ingestão de alimentos contaminados ou contato com fezes de gatos infectados. A prevalência da toxoplasmose varia globalmente, sendo mais comum em regiões tropicais e correlacionada com condições socioeconômicas. Estima-se que até 30% da população mundial já tenha entrado em contato com o parasita, e estudos no Brasil indicam uma prevalência significativa entre gestantes. A infecção por T. gondii durante a gestação pode resultar em complicações para o feto, como doença retiniana, com consequências que podem persistir até a idade adulta. O diagnóstico e tratamento da toxoplasmose congênita são essenciais para mitigar esses efeitos adversos. Este estudo realizou uma revisão integrativa da literatura, utilizando a estratégia PICo para investigar os impactos da desinformação sobre a toxoplasmose em gestantes. A pesquisa foi conduzida em bases de dados como MEDLINE, LILACS e Base de Dados de Enfermagem, resultando em uma seleção de 13 artigos para análise. Os resultados destacam a importância da sorologia para T. gondii durante o pré-natal e do monitoramento regular da gestante para detectar possíveis infecções agudas. O tratamento, quando necessário, deve ser iniciado prontamente para reduzir a transmissão vertical e a gravidade da doença congênita. Além disso, a falta de orientação preventiva adequada para gestantes suscetíveis ressalta a necessidade de capacitação dos profissionais de saúde para fornecer informações higiênicas e dietéticas pertinentes. Em conclusão, a toxoplasmose durante a gravidez representa uma preocupação significativa de saúde pública, exigindo medidas de prevenção eficazes e acesso a cuidados de saúde adequados. A conscientização pública e o investimento em pesquisa contínua são fundamentais para reduzir a incidência de toxoplasmose congênita e garantir melhores resultados para mães e bebês

INCONTINÊNCIA URINÁRIA DE ESFORÇOS EM MULHERES: UMA REVISÃO LITERÁRIA

Introduction:  Stress urinary incontinence (SUI) significantly impacts the quality of life of many women, especially postpartum and during menopause. It is characterized by the involuntary loss of urine during activities that increase intra-abdominal pressure. Objective:  This study systematically reviews the literature on SUI in women from 2019 to 2024 to analyze prevalence, risk factors, pathophysiology, psychosocial impact, diagnosis, and treatment. Methodology: Research was conducted in databases such as PubMed, Scopus, and Cochrane Library, using specific terms. Studies published between 2019 and 2024, addressing SUI in women were included. Results and Discussion: SUI prevalence ranges from 10% to 40%, influenced by age, parity, BMI, and menopause. Diagnosis involves clinical history, physical examination, and specific tests. Treatments include Kegel exercises, behavioral therapies, pharmacological, and surgical interventions. Conclusion: SUI is common and negatively affects women's lives. A multimodal treatment approach and education are essential to improve patients' quality of life.Introdução: A incontinência urinária por esforços (IUE) afeta significativamente a qualidade de vida de muitas mulheres, especialmente no pós-parto e na menopausa. Caracteriza-se pela perda involuntária de urina durante atividades que aumentam a pressão intra-abdominal. Objetivo: Este estudo revisa sistematicamente a literatura sobre IUE em mulheres, de 2019 a 2024, para analisar prevalência, fatores de risco, fisiopatologia, impacto psicossocial, diagnóstico e tratamento. Metodologia:  A pesquisa foi realizada em bases de dados como PubMed, Scopus e Cochrane Library, utilizando termos específicos. Foram incluídos estudos publicados entre 2019 e 2024, abordando a IUE em mulheres. Resultados e Discussão A prevalência de IUE varia entre 10% e 40%, influenciada por idade, paridade, IMC e menopausa. O diagnóstico envolve história clínica, exame físico e testes específicos. Tratamentos incluem exercícios de Kegel, terapias comportamentais, farmacológicas e cirúrgicas. Conclusão: A IUE é comum e afeta negativamente a vida das mulheres. A abordagem multimodal de tratamento e a educação são essenciais para melhorar a qualidade de vida das pacientes

Contributions of mean and shape of blood pressure distribution to worldwide trends and variations in raised blood pressure: A pooled analysis of 1018 population-based measurement studies with 88.6 million participants

© The Author(s) 2018. Background: Change in the prevalence of raised blood pressure could be due to both shifts in the entire distribution of blood pressure (representing the combined effects of public health interventions and secular trends) and changes in its high-blood-pressure tail (representing successful clinical interventions to control blood pressure in the hypertensive population). Our aim was to quantify the contributions of these two phenomena to the worldwide trends in the prevalence of raised blood pressure. Methods: We pooled 1018 population-based studies with blood pressure measurements on 88.6 million participants from 1985 to 2016. We first calculated mean systolic blood pressure (SBP), mean diastolic blood pressure (DBP) and prevalence of raised blood pressure by sex and 10-year age group from 20-29 years to 70-79 years in each study, taking into account complex survey design and survey sample weights, where relevant. We used a linear mixed effect model to quantify the association between (probittransformed) prevalence of raised blood pressure and age-group- and sex-specific mean blood pressure. We calculated the contributions of change in mean SBP and DBP, and of change in the prevalence-mean association, to the change in prevalence of raised blood pressure. Results: In 2005-16, at the same level of population mean SBP and DBP, men and women in South Asia and in Central Asia, the Middle East and North Africa would have the highest prevalence of raised blood pressure, and men and women in the highincome Asia Pacific and high-income Western regions would have the lowest. In most region-sex-age groups where the prevalence of raised blood pressure declined, one half or more of the decline was due to the decline in mean blood pressure. Where prevalence of raised blood pressure has increased, the change was entirely driven by increasing mean blood pressure, offset partly by the change in the prevalence-mean association. Conclusions: Change in mean blood pressure is the main driver of the worldwide change in the prevalence of raised blood pressure, but change in the high-blood-pressure tail of the distribution has also contributed to the change in prevalence, especially in older age groups

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Rising rural body-mass index is the main driver of the global obesity epidemic in adults

Body-mass index (BMI) has increased steadily in most countries in parallel with a rise in the proportion of the population who live in cities(.)(1,2) This has led to a widely reported view that urbanization is one of the most important drivers of the global rise in obesity(3-6). Here we use 2,009 population-based studies, with measurements of height and weight in more than 112 million adults, to report national, regional and global trends in mean BMI segregated by place of residence (a rural or urban area) from 1985 to 2017. We show that, contrary to the dominant paradigm, more than 55% of the global rise in mean BMI from 1985 to 2017-and more than 80% in some low- and middle-income regions-was due to increases in BMI in rural areas. This large contribution stems from the fact that, with the exception of women in sub-Saharan Africa, BMI is increasing at the same rate or faster in rural areas than in cities in low- and middle-income regions. These trends have in turn resulted in a closing-and in some countries reversal-of the gap in BMI between urban and rural areas in low- and middle-income countries, especially for women. In high-income and industrialized countries, we noted a persistently higher rural BMI, especially for women. There is an urgent need for an integrated approach to rural nutrition that enhances financial and physical access to healthy foods, to avoid replacing the rural undernutrition disadvantage in poor countries with a more general malnutrition disadvantage that entails excessive consumption of low-quality calories.Peer reviewe

Worldwide trends in underweight and obesity from 1990 to 2022: a pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults

Background Underweight and obesity are associated with adverse health outcomes throughout the life course. We estimated the individual and combined prevalence of underweight or thinness and obesity, and their changes, from 1990 to 2022 for adults and school-aged children and adolescents in 200 countries and territories. Methods We used data from 3663 population-based studies with 222 million participants that measured height and weight in representative samples of the general population. We used a Bayesian hierarchical model to estimate trends in the prevalence of different BMI categories, separately for adults (age ≥20 years) and school-aged children and adolescents (age 5–19 years), from 1990 to 2022 for 200 countries and territories. For adults, we report the individual and combined prevalence of underweight (BMI <18·5 kg/m2) and obesity (BMI ≥30 kg/m2). For schoolaged children and adolescents, we report thinness (BMI <2 SD below the median of the WHO growth reference) and obesity (BMI >2 SD above the median). Findings From 1990 to 2022, the combined prevalence of underweight and obesity in adults decreased in 11 countries (6%) for women and 17 (9%) for men with a posterior probability of at least 0·80 that the observed changes were true decreases. The combined prevalence increased in 162 countries (81%) for women and 140 countries (70%) for men with a posterior probability of at least 0·80. In 2022, the combined prevalence of underweight and obesity was highest in island nations in the Caribbean and Polynesia and Micronesia, and countries in the Middle East and north Africa. Obesity prevalence was higher than underweight with posterior probability of at least 0·80 in 177 countries (89%) for women and 145 (73%) for men in 2022, whereas the converse was true in 16 countries (8%) for women, and 39 (20%) for men. From 1990 to 2022, the combined prevalence of thinness and obesity decreased among girls in five countries (3%) and among boys in 15 countries (8%) with a posterior probability of at least 0·80, and increased among girls in 140 countries (70%) and boys in 137 countries (69%) with a posterior probability of at least 0·80. The countries with highest combined prevalence of thinness and obesity in school-aged children and adolescents in 2022 were in Polynesia and Micronesia and the Caribbean for both sexes, and Chile and Qatar for boys. Combined prevalence was also high in some countries in south Asia, such as India and Pakistan, where thinness remained prevalent despite having declined. In 2022, obesity in school-aged children and adolescents was more prevalent than thinness with a posterior probability of at least 0·80 among girls in 133 countries (67%) and boys in 125 countries (63%), whereas the converse was true in 35 countries (18%) and 42 countries (21%), respectively. In almost all countries for both adults and school-aged children and adolescents, the increases in double burden were driven by increases in obesity, and decreases in double burden by declining underweight or thinness. Interpretation The combined burden of underweight and obesity has increased in most countries, driven by an increase in obesity, while underweight and thinness remain prevalent in south Asia and parts of Africa. A healthy nutrition transition that enhances access to nutritious foods is needed to address the remaining burden of underweight while curbing and reversing the increase in obesit

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks

Impact of COVID-19 on cardiovascular testing in the United States versus the rest of the world

Objectives: This study sought to quantify and compare the decline in volumes of cardiovascular procedures between the United States and non-US institutions during the early phase of the coronavirus disease-2019 (COVID-19) pandemic. Background: The COVID-19 pandemic has disrupted the care of many non-COVID-19 illnesses. Reductions in diagnostic cardiovascular testing around the world have led to concerns over the implications of reduced testing for cardiovascular disease (CVD) morbidity and mortality. Methods: Data were submitted to the INCAPS-COVID (International Atomic Energy Agency Non-Invasive Cardiology Protocols Study of COVID-19), a multinational registry comprising 909 institutions in 108 countries (including 155 facilities in 40 U.S. states), assessing the impact of the COVID-19 pandemic on volumes of diagnostic cardiovascular procedures. Data were obtained for April 2020 and compared with volumes of baseline procedures from March 2019. We compared laboratory characteristics, practices, and procedure volumes between U.S. and non-U.S. facilities and between U.S. geographic regions and identified factors associated with volume reduction in the United States. Results: Reductions in the volumes of procedures in the United States were similar to those in non-U.S. facilities (68% vs. 63%, respectively; p = 0.237), although U.S. facilities reported greater reductions in invasive coronary angiography (69% vs. 53%, respectively; p < 0.001). Significantly more U.S. facilities reported increased use of telehealth and patient screening measures than non-U.S. facilities, such as temperature checks, symptom screenings, and COVID-19 testing. Reductions in volumes of procedures differed between U.S. regions, with larger declines observed in the Northeast (76%) and Midwest (74%) than in the South (62%) and West (44%). Prevalence of COVID-19, staff redeployments, outpatient centers, and urban centers were associated with greater reductions in volume in U.S. facilities in a multivariable analysis. Conclusions: We observed marked reductions in U.S. cardiovascular testing in the early phase of the pandemic and significant variability between U.S. regions. The association between reductions of volumes and COVID-19 prevalence in the United States highlighted the need for proactive efforts to maintain access to cardiovascular testing in areas most affected by outbreaks of COVID-19 infection