Original Paper

Clinical Research in Cardiology

, Volume 101, Issue 10, pp 805-813

Open Access This content is freely available online to anyone, anywhere at any time.

Green tea halts progression of cardiac transthyretin amyloidosis: an observational report

  • Arnt V. KristenAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg Email author 
  • , Stephanie LehrkeAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Sebastian BussAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Derliz MerelesAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Henning SteenAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Philipp EhlermannAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Stefan HardtAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Evangelos GiannitsisAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
  • , Rupert SchreinerAffiliated withLaboratory of Dr. Limbach and Associates
    • , Uwe HaberkornAffiliated withDepartment of Nuclear Medicine, University of Heidelberg
    • , Philipp A. SchnabelAffiliated withInstitute of Pathology, Heidelberg University
    • , Reinhold P. LinkeAffiliated withReference Center of Amyloid Diseases, amYmed
    • , Christoph RöckenAffiliated withInstitute of Pathology, Christian-Albrechts-University
    • , Erich E. WankerAffiliated withMax Delbrück Center for Molecular Medicine
    • , Thomas J. DenglerAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg
    • , Klaus AltlandAffiliated withInstitute of Human Genetics, Giessen University
    • , Hugo A. KatusAffiliated withDepartment of Cardiology, Angiology, and Respiratory Medicine, University Hospital Heidelberg

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.

Keywords

Cardiomyopathy Green tea Transthyretin-derived amyloidosis Epigallocatechin-3-gallate