Genomic screening programs and familial cascade genetic testing are increasingly uncovering pre-symptomatic <i>TTR</i>+ carriers, yet no guidelines exist to pragmatically risk stratify these individuals for CA.<h4>Methods</h4>V142I+ carriers (cases) without prior diagnoses of amyloidosis or HF were identified among Bio<i>Me</i> biobank participants with available exome sequencing data linked to electronic health records (EHRs) including at least one available echocardiogram. The gene discussed is TTR; the disease is amyloidosis.