Transthyretin amyloidosis (or ATTR amyloidosis) is an under-recognised multisystemic disorder, arising from misfolding of transthyretin proteins into insoluble amyloid fibrils. As amyloid fibrils deposit into various tissues and organs, the process invariably leads to organ dysfunction. Deposition of amyloid fibrils into the heart results in cardiac amyloidosis (CA). Manifestations include restrictive cardiomyopathy, heart failure, conduction abnormalities and arrhythmias. Early and accurate recognition of cardiac involvement is important, as it is a leading cause of morbidity and mortality in ATTR amyloidosis, and emerging therapies may delay disease progression.
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