We read with great interest the study by Pérez-Nieva and colleagues regarding the implementation of a systematic checklist-based strategy for the screening of transthyretin cardiac amyloidosis (ATTR-CM) [1]. This prospective multicenter investigation provides critical evidence that the proactive identification of clinical red flags can bridge the profound gap between underdiagnosis and the true prevalence of this condition in elderly heart failure populations. While the tenfold increase in diagnosis rates underscores the success of the strategy, this improvement likely reflects a combination of enhanced case-finding and evolving referral patterns depending on local CHECKAMIC implementation, and several critical issues warrant further discussion.
