Planta Med 2013; 79 - PA41
DOI: 10.1055/s-0033-1351945

Green Tea halts progression of cardiac involvement in senile systemic amyloidosis

F aus dem Siepen 1, SJ Buss 1, C Röcken 2, K Altland 3, HA Katus 1, AV Kristen 1
  • 1University Hospital Heidelberg, Department of Cardiology, Heidelberg, Germany
  • 2Christian-Albrechts-Universität Kiel, Institute for Pathology, Kiel, Germany
  • 3Justus-Liebig-Universität Gießen, Department of Human Genetics, Gießen, Germany

Amyloidosis labels a group of diseases that is characterized by aggregation of beta-sheated fibrillar proteins and deposit in the extracellular space. In general amyloid can be found in almost all organs, but senile systemic amyloidosis (SSA) is characterized by sole cardiac involvement resulting in organ dysfunction and finally organ failure. There is no causative therapy for patients with SSA and standard heart failure medication is not able to slow progression of the disease. Recent reports indicate the potential of epigallocatechin-3-gallate (EGCG), the most abundant catechin in green tea (GT), to inhibit fibril formation from several amyloidogenic proteins in in vitro experiments. We sought to investigate the effect of GT on patients with SSA.

15 male Patients (73.2 ± 7.8 kg) with histological proven SSA underwent echocardiography (EC), blood analysis and cardiac magnetic resonance imaging (CMR) before and after daily consumption of capsules containing 1200 mg of green tea extract with an EGCG content of at least 50% (extraction solvent: ethyl acetate/ethanol/water) for 12 months.

After 12 months of GT consumption a significant decrease of LV myocardial mass (-15.4 ± 32.9 g;-7 ± 15%;p < 0.05) was observed by CMR. LV ejection fraction remained unchanged (+1.7 ± 32.4%;p = 0.35). By EC no significant increase of left ventricular (LV) wall thickness (+1.8 ± 0.7%;p = 0.87) or decrease of mitral annular plane (MAP) velocity (-10.1 ± 19.1%;p = 0.39) were observed, but MAP systolic excursion decreased by 16.2 ± 21.6% (p < 0.05). Renal function remained unchanged (-4.1 ± 25.6%; p = 0.51). Moreover, a significant reduction of overall cholesterine was observed (-8.7 ± 35.5%; p < 0.05). No serious adverse events were reported by any of the participants.

Due to reduction of LV mass observed in the present study an inhibitory effect of GT on amyloid fibrils can be assumed during 12 months of treatment. Long-term effects and impact on the overall survival need to be confirmed in a larger placebo-controlled study.