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summary/abstract
For decades, cardiac amyloidosis was a diagnosis cardiologists whispered and patients rarely heard. The disease hides behind the fingerprints of ordinary heart failure. It masquerades as carpal tunnel syndrome. It sits inside aging hearts and waits. By the time doctors identified it, the heart was often too stiff to save. In 2026, that story has changed, and it has changed fast. Four therapies with four completely different mechanisms are now reshaping how cardiologists think about a disease that was considered untreatable less than a decade ago. For anyone interested in how longevity medicine meets real-world cardiology, the transthyretin amyloidosis, or ATTR, story is one of the most important case studies of the current era.