Medscape InDiscussion: ATTR-CM

Managing Heart Failure in ATTR-CM

From narrow volume windows to SGLT2 inhibitors and emerging devices, Drs Kevin Alexander and Sarah Cuddy discuss heart failure care in ATTR-CM. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep4-2026a10006he [https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep4-2026a10006he]. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Transthyretin-Related Amyloidosis https://emedicine.medscape.com/article/335301-overview [https://emedicine.medscape.com/article/335301-overview] Diversity of Heart Failure Phenotypes in Transthyretin Amyloid Cardiomyopathy. More Than Just Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/39460551/ [https://pubmed.ncbi.nlm.nih.gov/39460551/] Transthyretin Amyloid Cardiomyopathy: The Plot Thickens as Novel Therapies Emerge https://pubmed.ncbi.nlm.nih.gov/41210313/ [https://pubmed.ncbi.nlm.nih.gov/41210313/] The Role of SGLT2-Inhibitors Across All Stages of Heart Failure and Mechanisms of Early Clinical Benefit: From Prevention to Advanced Heart Failure https://pubmed.ncbi.nlm.nih.gov/40149587/ [https://pubmed.ncbi.nlm.nih.gov/40149587/] Mineralocorticoid Receptor Antagonists in Heart Failure: An Update https://pubmed.ncbi.nlm.nih.gov/39584253/ [https://pubmed.ncbi.nlm.nih.gov/39584253/] Primary Systemic Amyloidosis https://emedicine.medscape.com/article/1093258-overview [https://emedicine.medscape.com/article/1093258-overview] Guideline-Directed Medical Therapy Intolerance in Heart Failure https://pubmed.ncbi.nlm.nih.gov/39466259/ [https://pubmed.ncbi.nlm.nih.gov/39466259/] Conventional Heart Failure Therapy in Cardiac ATTR Amyloidosis https://pubmed.ncbi.nlm.nih.gov/37216684/ [https://pubmed.ncbi.nlm.nih.gov/37216684/] Device Therapies for Heart Failure With Reduced Ejection Fraction: A New Era https://pubmed.ncbi.nlm.nih.gov/39494238/ [https://pubmed.ncbi.nlm.nih.gov/39494238/] CardioMEMS Heart Failure System: An Up-to-Date Review https://pubmed.ncbi.nlm.nih.gov/39991420/ [https://pubmed.ncbi.nlm.nih.gov/39991420/] Mechanisms of Chronotropic Incompetence in Heart Failure With Preserved Ejection Fraction https://pubmed.ncbi.nlm.nih.gov/32164435/ [https://pubmed.ncbi.nlm.nih.gov/32164435/] Cardiac Resynchronization Therapy https://www.ncbi.nlm.nih.gov/books/NBK567773/ [https://www.ncbi.nlm.nih.gov/books/NBK567773/] Kidney Outcomes in Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/39550765/ [https://pubmed.ncbi.nlm.nih.gov/39550765/] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

Don't Miss the Zebra: AI in ATTR-CM

ATTR-CM is the zebra hiding among the horses. AI may finally be the tool that finds it. Experts Drs Kevin Alexander and Lily Stern explore what's working, what's not, and what comes next. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep3-2026a10006hb [https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep3-2026a10006hb]. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Transthyretin-Related Amyloidosis https://emedicine.medscape.com/article/335301-overview [https://emedicine.medscape.com/article/335301-overview] The Role of Artificial Intelligence in Cardiac Amyloidosis: A Focus on Diagnosis and Clinical Application https://pubmed.ncbi.nlm.nih.gov/40558656/ [https://pubmed.ncbi.nlm.nih.gov/40558656/] Concordance of Left Ventricular Volumes and Function Measurements Between Two Human Readers, a Fully Automated AI Algorithm, and the 3D Heart Model https://pubmed.ncbi.nlm.nih.gov/39081366/ [https://pubmed.ncbi.nlm.nih.gov/39081366/] High-Throughput Precision Phenotyping of Left Ventricular Hypertrophy With Cardiovascular Deep Learning https://pubmed.ncbi.nlm.nih.gov/35195663/ [https://pubmed.ncbi.nlm.nih.gov/35195663/] Eplontersen for Hereditary Transthyretin Amyloidosis With Polyneuropathy https://pubmed.ncbi.nlm.nih.gov/37768671/ [https://pubmed.ncbi.nlm.nih.gov/37768671/] Diagnosing AL and ATTR Amyloid Cardiomyopathy: A Multidisciplinary Approach https://pubmed.ncbi.nlm.nih.gov/39407933/ [https://pubmed.ncbi.nlm.nih.gov/39407933/] Advances in Imaging-Based Diagnosis, Prognosis, and Response Assessment in Cardiac Amyloidosis: A Comprehensive Multimodality Review https://pmc.ncbi.nlm.nih.gov/articles/PMC12450123/ [https://pmc.ncbi.nlm.nih.gov/articles/PMC12450123/] Exploring the Utility of Carpal Tunnel Biopsy in Amyloidosis: A Current Perspective https://pubmed.ncbi.nlm.nih.gov/39588898/ [https://pubmed.ncbi.nlm.nih.gov/39588898/] Design and Rationale the SCAN-MP (Screening for Cardiac Amyloidosis With Nuclear Imaging in Minority Populations) Study https://pubmed.ncbi.nlm.nih.gov/37066788/ [https://pubmed.ncbi.nlm.nih.gov/37066788/] Artificial Intelligence-Enhanced Electrocardiogram for the Early Detection of Cardiac Amyloidosis https://pubmed.ncbi.nlm.nih.gov/34218880/ [https://pubmed.ncbi.nlm.nih.gov/34218880/] Machine Learning-Based CT Angiography-Derived Fractional Flow Reserve for Diagnosis of Functionally Significant Coronary Artery Disease https://pubmed.ncbi.nlm.nih.gov/36889853/ [https://pubmed.ncbi.nlm.nih.gov/36889853/] NYHA Classification for Decision-Making in Heart Failure: Time to Reassess? https://pubmed.ncbi.nlm.nih.gov/37264724/ [https://pubmed.ncbi.nlm.nih.gov/37264724/] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

Can Early Genetic Testing Change ATTR-CM Outcomes?

Drs Kevin Alexander and Joban Vaishnav explore when and how to use genetic testing in ATTR-CM, why distinguishing hereditary from wild-type disease matters, and what this means for patients' families. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep2-2026a10006ha [https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep2-2026a10006ha]. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Transthyretin-Related Amyloidosis https://emedicine.medscape.com/article/335301-overview [https://emedicine.medscape.com/article/335301-overview] Tafamidis Treatment for Patients With Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/30145929/ [https://pubmed.ncbi.nlm.nih.gov/30145929/] Molecular Mechanisms and Emerging Therapies in Wild-Type Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/38233673/ [https://pubmed.ncbi.nlm.nih.gov/38233673/] Hereditary Transthyretin Amyloidosis (ATTRv) https://pubmed.ncbi.nlm.nih.gov/39954876/ [https://pubmed.ncbi.nlm.nih.gov/39954876/] 99mTc Bone-Avid Tracer Cardiac Scintigraphy: Role in Noninvasive Diagnosis of Transthyretin Cardiac Amyloidosis https://pubmed.ncbi.nlm.nih.gov/36537896/ [https://pubmed.ncbi.nlm.nih.gov/36537896/] Utility of Genetic Testing in Patients With Transthyretin Amyloid Cardiomyopathy: A Brief Review https://pubmed.ncbi.nlm.nih.gov/38275387/ [https://pubmed.ncbi.nlm.nih.gov/38275387/] Clinical Comparison of V122I Genotypic Variant of Transthyretin Amyloid Cardiomyopathy With Wild-Type and Other Hereditary Variants: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/33768376/ [https://pubmed.ncbi.nlm.nih.gov/33768376/] V122I TTR Cardiac Amyloidosis in Patients of African Descent: Recognizing a Missed Disease or the Dog That Didn't Bark?https://pubmed.ncbi.nlm.nih.gov/27618856/ [https://pubmed.ncbi.nlm.nih.gov/27618856/] Genetic and Clinical Features of Hereditary Transthyretin Amyloidosis: A Decade of Experience at a Japanese Referral Center https://pubmed.ncbi.nlm.nih.gov/40898332/ [https://pubmed.ncbi.nlm.nih.gov/40898332/] Effectiveness and Utility of Genetic Testing in Establishing a Diagnosis of Hereditary Transthyretin Amyloidosis https://pubmed.ncbi.nlm.nih.gov/41095902/ [https://pubmed.ncbi.nlm.nih.gov/41095902/] Acoramidis Transthyretin Amyloidosis Prevention Trial in the Young (ACT-EARLY) Study in Asymptomatic Carriers of a Pathogenic TTR Variant https://clinicaltrials.gov/study/NCT06563895 [https://clinicaltrials.gov/study/NCT06563895] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.

Rethinking Rhythm Control in ATTR-CM

Is rhythm control underused in ATTR-CM? Drs Kevin Alexander and Ronald Witteles make the case for rethinking how we manage arrhythmias in this disease. Relevant disclosures can be found with the episode show notes on Medscape https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep1-2026a10006h9 [https://www.medscape.com/ca8/p04/podcast-attr-cm-s1-ep1-2026a10006h9]. The topics and discussions are planned, produced, and reviewed independently of advertisers. This podcast is intended only for US healthcare professionals. Resources Transthyretin-Related Amyloidosis https://emedicine.medscape.com/article/335301-overview [https://emedicine.medscape.com/article/335301-overview] Primary Systemic Amyloidosis https://emedicine.medscape.com/article/1093258-overview [https://emedicine.medscape.com/article/1093258-overview] Arrhythmias in Patients With Cardiac Amyloidosis: A Comprehensive Review on Clinical Management and Devices https://pubmed.ncbi.nlm.nih.gov/37623350/ [https://pubmed.ncbi.nlm.nih.gov/37623350/] Atrial Fibrillation in the Setting of Cardiac Amyloidosis - A Review of the Literature https://pubmed.ncbi.nlm.nih.gov/38565394/ [https://pubmed.ncbi.nlm.nih.gov/38565394/] Atrial Fibrillation/Flutter in Transthyretin Cardiac Amyloidosis: Prevalence, Incidence, Clinical Predictors, and Effect of Tafamidis https://pubmed.ncbi.nlm.nih.gov/41448121/ [https://pubmed.ncbi.nlm.nih.gov/41448121/] Disease-Modifying Therapies in Transthyretin Amyloid Cardiomyopathy: What Have We Achieved https://pubmed.ncbi.nlm.nih.gov/41698526/ [https://pubmed.ncbi.nlm.nih.gov/41698526/] SGLT2 Inhibitor Therapy in Patients With Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/38866445/ [https://pubmed.ncbi.nlm.nih.gov/38866445/] Direct Oral Anticoagulants in Patients With Cardiac Amyloidosis: A Systematic Review and Meta-analysis https://pubmed.ncbi.nlm.nih.gov/38303916/ [https://pubmed.ncbi.nlm.nih.gov/38303916/] Pulsed Field Ablation of Atrial Fibrillation: A Comprehensive Review https://pubmed.ncbi.nlm.nih.gov/39076426/ [https://pubmed.ncbi.nlm.nih.gov/39076426/] Transthyretin Cardiac Amyloidosis Evaluation and Management: 2025 ACC Concise Clinical Guidance https://pubmed.ncbi.nlm.nih.gov/41171219/ [https://pubmed.ncbi.nlm.nih.gov/41171219/] 99m Technetium-Pyrophosphate Scintigraphy: A Practical Guide for Early Diagnosis of Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/34841715/ [https://pubmed.ncbi.nlm.nih.gov/34841715/] Biomarkers in Heart Failure: A Review and a Wish https://pubmed.ncbi.nlm.nih.gov/40869365/ [https://pubmed.ncbi.nlm.nih.gov/40869365/] Tafamidis Treatment for Patients With Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/30145929/ [https://pubmed.ncbi.nlm.nih.gov/30145929/] Safety of Direct Current Cardioversion Without Routine Transesophageal Echocardiography in Patients With Cardiac Amyloidosis https://pubmed.ncbi.nlm.nih.gov/39111975/ [https://pubmed.ncbi.nlm.nih.gov/39111975/] Efficacy and Safety of Acoramidis in Transthyretin Amyloid Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/38197816/ [https://pubmed.ncbi.nlm.nih.gov/38197816/] Vutrisiran in Patients With Transthyretin Amyloidosis With Cardiomyopathy https://pubmed.ncbi.nlm.nih.gov/39213194/ [https://pubmed.ncbi.nlm.nih.gov/39213194/] CARDIO-TTRansform: A Study to Evaluate the Efficacy and Safety of Eplontersen (Formerly Known as ION-682884, IONIS-TTR-LRx and AKCEA-TTR-LRx) in Participants With Transthyretin-Mediated Amyloid Cardiomyopathy (ATTR CM) https://clinicaltrials.gov/study/NCT04136171 [https://clinicaltrials.gov/study/NCT04136171] Prevalence and Functional Impact of Chronotropic Incompetence in Amyloid Cardiomyopathy: A Multicentre Analysis https://pubmed.ncbi.nlm.nih.gov/39794925/ [https://pubmed.ncbi.nlm.nih.gov/39794925/] Cardiac Resynchronization Therapy: Current Guidelines and Recent Advances Beyond Drug Treatment https://pubmed.ncbi.nlm.nih.gov/37246328/ [https://pubmed.ncbi.nlm.nih.gov/37246328/] Percutaneous Left Atrial Appendage Closure With the Watchman Device: A Systematic Review https://pubmed.ncbi.nlm.nih.gov/38616940/ [https://pubmed.ncbi.nlm.nih.gov/38616940/] Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com [https://pcm.adswizz.com] for information about our collection and use of personal data for advertising.