Transthyretin Amyloid Cardiomyopathy: A Rapidly Evolving Landscape

Transthyretin amyloid cardiomyopathy (ATTR-CM) has emerged as a significant yet underdiagnosed cause of heart failure. Advancements in the noninvasive imaging that facilitates diagnosis at an earlier stage of disease and treatment have marked a paradigm shift in the management of this previously fatal disease. This review outlines the epidemiology, pathophysiology, diagnosis, and treatment of ATTR-CM, with an emphasis on the recent developments transforming the field, including an ability to diagnose most patients without a biopsy, the shift toward screening or active ascertainment, the development of several new therapies, and a better understanding of how to employ standard heart failure therapies in patients with this disease. Additionally, the review explores questions that have emerged from these developments.