{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T16:43:17Z","timestamp":1786293797974,"version":"build-2736575974"},"reference-count":4,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000},"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":["Echocardiography"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>We present the case of a 52\u2010year\u2010old male with severe primary mitral regurgitation, with biventricular dilatation and systolic impairment. Pre\u2010operative exercise stress echocardiography revealed absence of left and right ventricular contractile reserve suggestive\u00a0of increased surgical risk possibly requiring postoperative\u00a0mechanical circulatory support. In the immediate postoperative period, the transesophageal echocardiogram revealed severe left ventricular systolic impairment with very low cardiac output, resulting in\u00a0significant challenges in weaning the\u00a0patient off cardiopulmonary bypass.\u00a0Left ventricular function\u00a0gradually improved with\u00a0judicious\u00a0use of\u00a0intravenous fluids and inotropic\u00a0support. Our case highlights the importance of stress echocardiography in the risk stratification and periprocedural planning of patients undergoing cardiac surgery for severe mitral regurgitation.<\/jats:p>","DOI":"10.1111\/echo.70473","type":"journal-article","created":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T17:47:35Z","timestamp":1777052855000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Heart Under Stress: What Happens When Both Ventricles Fail?"],"prefix":"10.1111","volume":"43","author":[{"given":"Maria","family":"Vlachou","sequence":"first","affiliation":[{"name":"Department of Echocardiography Royal Brompton Hospital Guy's and St. Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rashmi","family":"Yadav","sequence":"additional","affiliation":[{"name":"Cardiothoracic Department Royal Brompton Hospital, Guy's and St. Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rajdeep Singh","family":"Khattar","sequence":"additional","affiliation":[{"name":"Department of Echocardiography Royal Brompton Hospital Guy's and St. Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxy","family":"Senior","sequence":"additional","affiliation":[{"name":"Department of Echocardiography Royal Brompton Hospital Guy's and St. Thomas' NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3667-8887","authenticated-orcid":false,"given":"Anastasia","family":"Vamvakidou","sequence":"additional","affiliation":[{"name":"Department of Echocardiography Royal Brompton Hospital Guy's and St. Thomas' NHS Foundation Trust  London UK"},{"name":"Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,24]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf194"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.echo.2016.10.016"},{"key":"e_1_2_4_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2005.074815"},{"key":"e_1_2_4_5_1","doi-asserted-by":"publisher","DOI":"10.1136\/hrt.2004.047613"}],"container-title":["Echocardiography"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70473","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/echo.70473","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/echo.70473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,9]],"date-time":"2026-08-09T16:26:35Z","timestamp":1786292795000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/echo.70473"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,24]]},"references-count":4,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1111\/echo.70473"],"URL":"https:\/\/doi.org\/10.1111\/echo.70473","archive":["Portico"],"relation":{},"ISSN":["0742-2822","1540-8175"],"issn-type":[{"value":"0742-2822","type":"print"},{"value":"1540-8175","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,24]]},"assertion":[{"value":"2026-03-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-07","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-04-24","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70473"}}