TTR and amyloidosis: In systemic light chain amyloidosis (AL) - due to a clonal plasma cell disorder - the heart is involved in 50% patients; the symptom progression is most commonly rapid and mortality higher compared to other types of amyloidosis.35 In cardiac transthyretin amyloidosis (TTR) - due to amyloid fibrils from liver-derived transthyretin - the heart is involved less frequently and heart symptoms occur at older ages.1 Deposits induce oxidant stress and lead to myocardial necrosis and interstitial fibrosis resulting in systolic and diastolic dysfunction.10