title: Green tea extract as a treatment for patients with wild-type transthyretin amyloidosis: an observational study.
abstract: BACKGROUND
  Causative treatment of patients with wild-type transthyretin amyloid cardiomyopathy (wtATTR-CM) is lacking. Recent reports indicate the potential use of epigallocatechin-3-gallate (EGCG), the most abundant catechin in green tea, to inhibit amyloid fibril formation. We sought to investigate changes of cardiac function and morphology in patients with wtATTR-CM after consumption of green tea extract (GTE).
  
  
  METHODS
  Twenty-five male patients (71 [64; 80] years) with wtATTR-CM were submitted to clinical examination, echocardiography, cardiac magnetic resonance imaging (cMRI) (n=14), and laboratory testing before and after daily consumption of GTE capsules containing 600 mg epigallocatechin-3-gallate for at least 12 months.
  
  
  RESULTS
  A significant decrease of left ventricular (LV) myocardial mass by 6% (196 [100; 247] vs 180 [85; 237] g; P=0.03) by cMRI and total cholesterol by 8.4% (191 [118; 267] vs 173 [106; 287] mg/dL; P=0.006) was observed after a 1-year period of GTE consumption. LV ejection fraction by cMRI (53% [33%; 69%] vs 54% [28%; 71%]; P=0.75), LV wall thickness (17 [13; 21] vs 18 [14; 25] mm; P=0.1), and mitral annular plane systolic excursion (10 [5; 23] vs 8 [4; 13] mm; P=0.3) by echocardiography remained unchanged.
  
  
  CONCLUSIONS
  This study supports LV mass stabilization in patients with wtATTR-CM consuming GTE potentially indicating amyloid fibril reduction.
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: aus dem Siepen
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Ralf
authors.initials: R
authors.lastname: Bauer
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Aurich
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Sebastian J
authors.initials: SJ
authors.lastname: Buss
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Henning
authors.initials: H
authors.lastname: Steen
authors.affiliation: Institute of Human Genetics, Justus-Liebig-University, Giessen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Altland
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Hugo A
authors.initials: HA
authors.lastname: Katus
authors.affiliation: Department of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg, Heidelberg, Germany.
authors.forename: Arnt V
authors.initials: AV
authors.lastname: Kristen
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000682:Amyloid / Q000037:antagonists & inhibitors / Q000378:metabolism; D028227:Amyloid Neuropathies, Familial / Q000175:diagnosis / Q000188:drug therapy*; D002392:Catechin / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000302:isolation & purification / Q000494:pharmacology / Q000627:therapeutic use; D015331:Cohort Studies; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D010936:Plant Extracts / Q000008:administration & dosage / Q000302:isolation & purification / Q000494:pharmacology* / Q000627:therapeutic use*; D013662:Tea / Q000737:chemistry*
chemical_list: D000682:Amyloid; D010936:Plant Extracts; D013662:Tea; D002392:Catechin; C045651:epigallocatechin gallate
keywords: EGCG; cardiomyopathy; polyphenol; wild-type ATTR