Cardiac Amyloidosis: Is It Truly a Hypertrophic Phenotype Cardiomyopathy?

Cardiac amyloidosis is a classic example of an infiltrative disease whose predominant phenotype is characterized by a hypertrophic pattern of myocardial involvement.^, The most relevant studies—both those focused on the development of disease-modifying therapies and cohorts evaluating diagnostic tools—have used increased ventricular wall thickness as a key criterion for suspecting cardiac amyloidosis.^– Based on this concept, several diagnostic algorithms have proposed ventricular wall thickening as one of the major red flags for investigating amyloid cardiomyopathy.^,

However, increased ventricular wall thickness does not appear to be a universal requirement for diagnosis. Emerging evidence suggests that both Immunoglobulin Light Chain Amyloidosis (AL) and Transthyretin Amyloidosis (ATTR) amyloidosis can be diagnosed, including through noninvasive methods, even in the absence of the classic hypertrophic phenotype.

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