Published: 20 February 2026
Author(s): Aldostefano Porcari, Sarah AM Cuddy, Marco Metra, Michele Emdin, Marianna Fontana, Julian D Gillmore
Section: Review Article

Transthyretin amyloid cardiomyopathy (ATTR-CM) has been traditionally considered a rare and inexorably fatal condition. However, the development of therapies able to slow or halt ATTR-CM progression and increase survival have transformed the management of this condition. As these treatments become more accessible, the need for clinical indicators of disease progression has become increasingly important to guide clinical decision-making and personalise treatment strategies. Changes in widely available parameters have been shown to track disease evolution, which include worsening heart failure symptoms, outpatient diuretic initiation or intensification, decline in the 6-minute walk test, N-terminal pro-B-type natriuretic peptide, estimated glomerular filtration rate, and structural and functional parameters on cardiac imaging.

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