576 Green Tea Reduces Left Ventricular Myocardial Mass in Patients with Transthyretin Amyloidosis
Author: A.V. Kristen and S. Lehrke and D. Mereles and P.A. Schnabel and C. Röcken and P. Ehlermann and T.J. Dengler and K. Altland and H.A. Katus
Purpose: Cardiac involvement is common in both forms of transthyretin (TTR) amyloidosis, variant and non-variant (senile) form. As no medical treatment is available yet liver transplantation is the only accepted treatment for patients with variant TTR amyloidosis and mild cardiac invovlement, but not for patients with senile amyloidosis. In patient with advanced cardiac amyloidosis heart transplantation is the only available treatment option. In 2007, a patient having ALA amyloidosis described a decrease of his LV wall after daily consumption of 2 1 of green tea (Hunstein, Blood 2007 110:2216). This prospective, open-label, single center interventional trial was performed to confirm the observation in patients with amyloid TTR cardiomyopathy. Methods and Materials: 19 patients with cardiac TTR amyloidosis were evaluated by standard blood tests, echocardiography, and cardiac MRI (n=9) while consuming green tea and/or green tea extract for 12 months. 5 patients were not followed-up for reasons of death (n=2), poor health (n=2), and heart transplantation (n=1). Results: After consumption of green tea and/or green tea extract for 12 months a significant average decline of LV myocardial mass was observed by echo (-15%) and MRI (-10%) accompanied by an increase of mitral annular systolic velocity (9%). In 11 of 14 (79%) patients we observed a reduction of cardiac mass by acho and by MRI in 9/9 (100%) suggesting a loss of cardiac amyloid. In all 14 patients total cholesterol (191.9 ± 8.9 mg/dL vs. 172.7 ± 9.4 mg/dL; p<0.01) and LDL cholesterol (105.8 ± 7.6 mg/dL vs 89.5 ± 8.0 mg/dL; p<0.01) decreased significantly during the observational period. NT-proBNP plasma levels remained unchanged. No serious adverse side-effects were reported by any of the participants. Conclusions: Consumption of green tea and green tea extracts appear to represent a promising therapeutic tool to halt the progression of the amyloid apposition and even decreases the cardiac amyloid load in patients with TTR amyloidosis. Thus, it is a promising treatment approach that might prevent heart transplantation.