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Figure 23 Diagnosis and treatment of cardiac amyloidosis in heart failure patients. 99mTc, technetium-99m; AL, immunoglobulin light chain; AL-CA, immunoglobulin light chain cardiac amyloidosis; ATTR-CA, transthyretin cardiac amyloidosis; CA, cardiac amyloidosis; CMR, cardiac magnetic resonance; DPD, 3,3-diphosphono-1,2-propanodicarboxylic acid; HMDP, hydroxymethylene diphosphonate; LVH, left ventricular hypertrophy; PYP, pyrophosphate; SPECT, single-photon emission computed tomography; TTR, transthyretin. aSee Table 20. bUsually an extracardiac biopsy is performed first. cPerform TTR genetic testing. dDiagnosis will be based on the results from the individualized approach. Downloaded from academic.oup.com/eurheartj/advance-article/doi/10.1093/eurheartj/ehag100/8766302 by guest on 31 August 2026