May 2022 Br J Cardiol 2022;29:73–6 doi:10.5837/bjc.2022.019
Joshua Dower, Danai Dima, Mumtu Lalla, Ayan R Patel, Raymond L Comenzo, Cindy Varga
Introduction Transthyretin (ATTR) cardiac amyloidosis is a disorder characterised by the deposition of amyloid fibrils into the heart’s extracellular space.1,2 Over time, this condition leads to restrictive cardiomyopathy and heart failure. Most cases are caused by abnormal plasma cell proliferation leading to misfolded light chains (AL amyloidosis) or misaggregation of the transthyretin protein (ATTR).3,4 Cardiac amyloidosis is widely considered to be underdiagnosed as patients often present in the late stages of disease.2,5 Endomyocardial biopsy can be utilised to diagnose ATTR cardiomyopathy by demonstrating amyloid proteins on Congo red
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