Advances in understanding, diagnosis and targeting ATTR cardiomyopathy: a review

Transthyretin amyloidosis (ATTR) manifests as wild-type (ATTRwt) and hereditary/mutant (ATTRv) forms and can lead to heart failure due to cardiac amyloidopathy. Diagnosing ATTR, particularly in asymptomatic carriers of pathogenic variants, remains challenging despite the advances. Complex and multi-aspect management involves a limited range of well-examined conventional therapies to address the heart failure and frequently coexisting arrhythmias and valvular issues. Disease-modifying treatment, RNA-based treatments, CRISPR-Cas9 gene editing and monoclonal antibodies targeting amyloid deposits are recent and promising innovations. This review explores the diagnostic intricacies, therapeutic dilemmas and emerging solutions in ATTR cardiomyopathy. The significance of early detection and precise, targeted approaches to enhance patient outcomes is underscored.