title: Green tea halts progression of cardiac transthyretin amyloidosis: an observational report.
abstract: BACKGROUND
  Treatment options in patients with amyloidotic transthyretin (ATTR) cardiomyopathy are limited. Epigallocatechin-3-gallate (EGCG), the most abundant catechin in green tea (GT), inhibits fibril formation from several amyloidogenic proteins in vitro. Thus, it might also halt progression of TTR amyloidosis. This is a single-center observational report on the effects of GT consumption in patients with ATTR cardiomopathy.
  
  
  METHODS
  19 patients with ATTR cardiomyopathy were evaluated by standard blood tests, echocardiography, and cardiac MRI (n = 9) before and after consumption of GT and/or green tea extracts (GTE) for 12 months.
  
  
  RESULTS
  Five patients were not followed up for reasons of death (n = 2), discontinuation of GT/GTE consumption (n = 2), and heart transplantation (n = 1). After 12 months no increase of left ventricular (LV) wall thickness and LV myocardial mass was observed by echocardiography. In the subgroup of patients evaluated by cardiac MRI a mean decrease of LV myocardial mass (-12.5 %) was detected in all patients. This was accompanied by an increase of mean mitral annular systolic velocity of 9 % in all 14 patients. Total cholesterol (191.9 ± 8.9 vs. 172.7 ± 9.4 mg/dL; p < 0.01) and LDL cholesterol (105.8 ± 7.6 vs. 89.5 ± 8.0 mg/dL; p < 0.01) decreased significantly during the observational period. No serious adverse effects were reported by any of the participants.
  
  
  CONCLUSIONS
  Our observation suggests an inhibitory effect of GT and/or GTE on the progression of cardiac amyloidosis. We propose a randomized placebo-controlled investigation to confirm our observation.
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Im Neuenheimer Feld 410, 69120 Heidelberg, Germany. Arnt_Kristen@med.uni-heidelberg.de
authors.forename: Arnt V
authors.initials: AV
authors.lastname: Kristen
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lehrke
authors.forename: Sebastian
authors.initials: S
authors.lastname: Buss
authors.forename: Derliz
authors.initials: D
authors.lastname: Mereles
authors.forename: Henning
authors.initials: H
authors.lastname: Steen
authors.forename: Philipp
authors.initials: P
authors.lastname: Ehlermann
authors.forename: Stefan
authors.initials: S
authors.lastname: Hardt
authors.forename: Evangelos
authors.initials: E
authors.lastname: Giannitsis
authors.forename: Rupert
authors.initials: R
authors.lastname: Schreiner
authors.forename: Uwe
authors.initials: U
authors.lastname: Haberkorn
authors.forename: Philipp A
authors.initials: PA
authors.lastname: Schnabel
authors.forename: Reinhold P
authors.initials: RP
authors.lastname: Linke
authors.forename: Christoph
authors.initials: C
authors.lastname: Röcken
authors.forename: Erich E
authors.initials: EE
authors.lastname: Wanker
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Dengler
authors.forename: Klaus
authors.initials: K
authors.lastname: Altland
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
mesh_terms: D000368:Aged; D028227:Amyloid Neuropathies, Familial / Q000188:drug therapy* / Q000503:physiopathology; D009202:Cardiomyopathies / Q000188:drug therapy* / Q000503:physiopathology; D002392:Catechin / Q000031:analogs & derivatives* / Q000302:isolation & purification / Q000494:pharmacology; D002784:Cholesterol / Q000097:blood; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000187:drug effects / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000378:metabolism; D010936:Plant Extracts / Q000494:pharmacology; D013662:Tea / Q000737:chemistry*
chemical_list: D010936:Plant Extracts; D013662:Tea; D002392:Catechin; D002784:Cholesterol; C045651:epigallocatechin gallate