Individualized Exercise Training in Cardiac Amyloidosis

Numerous clinical trials have demonstrated that transthyretin (TTR)-directed medical therapies can reduce the rate of functional decline in patients with transthyretin cardiac amyloidosis (ATTR-CM). However, patients treated with these therapies often experience a progressive reduction in exercise capacity despite treatment. Further, no randomized controlled trials (RCTs) have assessed the effects of exercise intervention in patients with ATTR-CM receiving TTR-directed therapy.

Inclusion Criteria: * Clinical diagnosis of ATTR-cardiac amyloidosis * Able to perform endurance and resistance exercise * Currently on stable dose of TTR-directed therapy, if on therapy * Adequate clinical stability has been achieved (in the judgment of the investigator) to allow participation in study assessments and intervention. * Signed informed consent indicating that the patient understands the purpose of the study, the procedures required and is willing to participate Exclusion Criteria: * Sustained ventricular arrhythmias or ICD shock within 6 months * Severe valvular stenosis * Pregnancy * Recent acute coronary syndrome or coronary artery bypass \< 6 months * Large pericardial effusion * Recent acute myocarditis (\< 3 months) * Recent cardiac medication changes for management of cardiomyopathy * Patients with investigational intracardiac devices