The initial diagnostic assessment of a patient with suspected cardiac amyloidosis involves a comprehensive examination; the main findings are represented by clinical heart failure (HF) symptoms and paraclinical data such as myocardial hypertrophy (>12 mm) discordance with low voltage on ECG, increased NT proBNP levels, low-flow, low-gradient aortic stenosis, myocardial granular sparkling, abnormal left ventricular global longitudinal change, and others, representing common settings in which clinical suspicion of amyloidosis should be raised [7,8]. This evidence concerns the gene NPPB and heart failure.