Advancing the Diagnosis and Management of Cardiac Amyloidosis

Cardiac amyloidosis remains an under-recognised cause of heart failure. Too often, patients are treated for “standard” heart failure for months or even years before the underlying diagnosis is identified. Yet we now know that early recognition and timely intervention can significantly improve outcomes and quality of life. Kent and London Cardiology’s Dr Suzan Hatipoglu explains recent developments.

A Transformation in Diagnosis: Non-Biopsy Criteria for ATTR Cardiac Amyloidosis

One of the most important advances in recent years has been the development of non-biopsy diagnostic criteria for transthyretin (ATTR) cardiac amyloidosis. Pioneered by Julian Gillmore and colleagues, this approach has transformed clinical practice by enabling accurate, non-invasive diagnosis in appropriate patients.

Historically, confirming cardiac amyloidosis often required an invasive heart biopsy. Today, in carefully selected individuals, a combination of imaging and blood tests can establish the diagnosis without the need for tissue sampling. This shift has:

• Reduced delays in diagnosis

• Minimized procedural risk

• Improved access to specialist treatment

• Enabled earlier initiation of disease-modifying therapy

I have had the privilege of working with the team involved in developing and implementing these criteria, and I continue to support their integration into routine clinical care.

Alignment with 2025 ACC Clinical Guidance

These diagnostic advances are reinforced by the American College of Cardiology 2025 Concise Clinical Guidance, which emphasises:

• Systematic evaluation of patients with suspected cardiac amyloidosis

• Early recognition of “red flag” features

• Clear diagnostic pathways

• Personalised management strategies

This guidance reflects a broader shift in cardiology toward precision medicine — ensuring that patients receive the right diagnosis and the right treatment at the right time.

A Rapidly Evolving Therapeutic Landscape

The treatment landscape for ATTR cardiac amyloidosis is evolving at pace. In England, new disease-modifying therapies are now available, offering the possibility of slowing disease progression rather than simply managing symptoms.

As options expand, informed and individualised treatment selection becomes increasingly important. Decisions must take into account:

• Disease stage

• Comorbidities

• Genetic status (in hereditary ATTR)

• Patient priorities and preferences

This is a pivotal moment in amyloidosis care. Early and accurate diagnosis now directly opens the door to therapies that can meaningfully alter the course of disease.

International Collaboration to Improve Patient Outcomes

We are delighted that Kent and London Cardiology’s own Dr Suzan Hatipoglu has been invited to join the Amyloidosis Working Group of the International Cardio-Oncology Society. This group brings together international experts committed to advancing research, education, and best practice in the care of patients with amyloidosis.

Through collaboration and shared expertise, we aim to improve awareness, standardise care pathways, and ultimately enhance outcomes for patients worldwide.

If you or a family member have been diagnosed with heart failure of unclear cause — particularly with features such as increased heart wall thickness, unexplained symptoms, or a history suggestive of amyloidosis — specialist assessment may be appropriate. Early evaluation can make a meaningful difference.

Please feel free to contact the practice for further information or to arrange a consultation.