Cardiac Amyloidosis: Is It Truly a Hypertrophic PhenotypeCardiomyopathy?

Cardiac amyloidosis is a classic example of an infiltrative
disease whose predominant phenotype is characterized by a
hypertrophic pattern of myocardial involvement.¹,
² 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.1-6 Based on
this concept, several diagnostic algorithms have proposed
ventricular wall thickening as one of the major red flags for
investigating amyloid cardiomyopathy.¹,
²
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