Our study showed that the patients with the TTR gene mutation without cardiac involvement at transthoracic echocardiogram on the basis of the current known criteria (low IWT score, absence of increased left-ventricular wall thickness, normal values of tissue velocities and normal GLS, normal diastolic function) also had decreased GLS value; in particular, we observed a gradual increase in the SAB and RAS from carriers to patients with neurological involvement and to patients with cardiac amyloidosis. The gene discussed is TTR; the disease is cardiac amyloidosis.