Alongside impaired cardiac function, individuals with CA suffer from symptoms of HF and declined functional capacity, particularly in advanced stages of the disease.1,2 In our current investigation, we observed significant differences in NT-proBNP, troponin T, and 6MWD between ATTR-CA patients in the low and high DPD uptake cohorts, implying that a higher DPD retention index is related to increased cardiac biomarkers, diminished exercise capacity, and advanced disease severity. Here, NPPB is linked to hydrops fetalis.