The prognosis of immunoglobulin light-chain (AL or primary systemic) and transthyretin (ATTR) amyloidosis is substantially influenced by the presence and severity of cardiac involvement, which then governs therapeutic strategies.1,2 Although blood biomarkers are useful guides for risk stratification,3 they are not specific for cardiac involvement, and current strategies do not ascertain all patients at risk. This evidence concerns the gene TTR and axial length measurement.