{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T06:25:35Z","timestamp":1787120735941,"version":"build-2736575974"},"reference-count":10,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T00:00:00Z","timestamp":1783641600000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Case Reports"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Pulmonary arterial hypertension may mask underlying atrial septal defects by reducing left\u2010to\u2010right shunt flow through elevated pulmonary vascular resistance and impaired right ventricular compliance. Targeted therapy may unmask latent defects, emphasizing early multimodality imaging and sustained clinical suspicion for congenital shunts when invasive hemodynamic assessment suggests shunting despite inconclusive echocardiography.<\/jats:p>","DOI":"10.1002\/ccr3.73125","type":"journal-article","created":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T08:26:23Z","timestamp":1783671983000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Hemodynamic Unmasking of Atrial Septal Defect After Pulmonary Arterial Hypertension Therapy: A Pathophysiologic Perspective"],"prefix":"10.1002","volume":"14","author":[{"given":"Nwachukwu O.","family":"Nwachukwu","sequence":"first","affiliation":[{"name":"Darlington Memorial Hospital  Darlington UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0249-1865","authenticated-orcid":false,"given":"Chukwuka","family":"Elendu","sequence":"additional","affiliation":[{"name":"Federal University Teaching Hospital  Owerri Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chimaobi","family":"Nwevo","sequence":"additional","affiliation":[{"name":"NYC Health + Hospitals\/South Brooklyn Health  Brooklyn New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davidson J.","family":"Ozoemena","sequence":"additional","affiliation":[{"name":"Wayne State University  Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emmanuel O.","family":"Ikechukwu","sequence":"additional","affiliation":[{"name":"Enugu State University of Science and Technology  Enugu Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nwamaka C.","family":"Bob\u2010Ume","sequence":"additional","affiliation":[{"name":"All Saints University College of Medicine  Kingstown Saint Vincent and the Grenadines"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ebiere S.","family":"Kalama","sequence":"additional","affiliation":[{"name":"Niger Delta University  Amassoma Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,10]]},"reference":[{"key":"e_1_2_1_10_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccr3.71656"},{"key":"e_1_2_1_10_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab646"},{"key":"e_1_2_1_10_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa554"},{"key":"e_1_2_1_10_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl\u20102021\u2010319096"},{"key":"e_1_2_1_10_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeaa314"},{"key":"e_1_2_1_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ihj.2013.03.003"},{"key":"e_1_2_1_10_8_1","doi-asserted-by":"publisher","DOI":"10.4137\/CMC.S15715"},{"key":"e_1_2_1_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jjcc.2014.09.002"},{"key":"e_1_2_1_10_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0099\u20102020"},{"key":"e_1_2_1_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jccase.2022.08.003"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73125","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccr3.73125","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.73125","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T05:34:03Z","timestamp":1787117643000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.73125"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/ccr3.73125"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.73125","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2026-02-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-01","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e73125"}}