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.
Zeldin et al. (2026) studied this question.