In transthyretin (TTR) amyloid cardiomyopathy (ATTR-CM), high left ventricular (LV) amyloid load is associated with cardiac dysfunction, including worse global longitudinal strain and elevated cardiac biomarkers.1 Serum TTR concentrations are useful for monitoring the response to stabilizer therapy.2 However, it remains unclear whether routine assessment of serum TTR provides diagnostic or risk-stratifying information in ATTR-CM. We hypothesized that lower serum TTR concentrations at first presentation are associated with higher LV amyloid load, whereas higher serum TTR concentrations reflect a less advanced disease stage. We investigated serum TTR concentrations at first contact for 77 patients with suspected ATTR-CM from our ongoing prospective clinical study.1
