Green tea extract as a treatment for patients with wild-type transthyretin amyloidosis: an observational study

Figures & data

Table 1 Baseline characteristics

	wtATTR overall (n=25)	cMRI subgroup (n=14)	P-value
Age (years)	71 (64; 80)	71 (64; 80)	ns
Body weight (kg)	80 (64; 105)	80 (64; 105)	ns
Height (cm)	173 (158; 190)	177 (168; 190)	ns
BMI (kg/m^2)	26 (20; 32)	27 (20; 32)	ns
NYHA class
I	14 (56%)	7 (50%)
II	5 (20%)	4 (29%)
III	6 (24%)	3 (21%)
Length of disease (months)	8.2	7.8	ns
ECG
Sinus rhythm	21	12
Atrial fibrillation	4	2
Heart rate (1/min)	75 (56; 91)	73 (56; 91)	ns
PQ (ms)	184 (166; 246)	184 (166; 246)	ns
QRS (ms)	117 (84; 176)	116 (84; 170)	ns
QTc (ms)	456 (410; 494)	440 (410; 498)	ns

Note: Continuous data are expressed as median (range).

Abbreviations: cMRI, cardiac magnetic resonance imaging; ns, nonsignificant; wtATTR, wild-type transthyretin amyloidosis; BMI, body mass index; ECG, electrocardiogram; NYHA, New York Heart Association.

Table 2 Blood analysis

	Study inclusion (n=25)	12 months after study start (n=21)	P-value
Creatinine (mg/dL)	1.2 (0.81; 2.3)	1.4 (0.79; 2.6)	ns
MDRD (mL/min)	62 (31; 99)	57 (26; 101)	ns
GOT (U/L)	30 (16; 56)	33 (17; 74)	ns
GPT (U/L)	29 (10; 57)	29 (10; 74)	ns
Cholesterol (mg/dL)	191 (118; 267)	173 (106; 287)	0.006
HDL (mg/dL)	48 (30; 78)	46 (31; 75)	ns
LDL (mg/dL)	124 (60; 180)	99 (55; 188)	0.02

Note: Continuous data are expressed as median (range).

Abbreviations: GOT, glutamic-oxaloacetic transaminase; GPT, glutamic-pyruvic transaminase; HDL, high-density lipoprotein; LDL, low-density lipoprotein; MDRD, modified diet in renal disease; ns, nonsignificant.

Figure 1 Laboratory testing.

Notes: Levels of cholesterol (A), LDL cholesterol (B), NT-proBNP (C), and glomerular filtration rate calculated using the MDRD formula (D) of individual patients with wtATTR-CM determined by cMRI before and after 12 months of green tea extract consumption.
Abbreviations: cMRI, cardiac magnetic resonance imaging; LDL, low-density lipoprotein; MDRD, modified diet in renal disease; t₀, baseline; t₁₂, at 12 months; wtATTR-CM, wild-type transthyretin amyloid cardiomyopathy; NT-proBNP, N-terminal prohormone of brain natriuretic peptide.

Figure 2 Echocardiography findings.

Notes: Interventricular septum thickness (A) and inferior wall thickness (B) of individual patients with wtATTR-CM determined by echocardiography before and after 12 months of green tea extract consumption.
Abbreviations: t₀, baseline; t₁₂, at 12 months; wtATTR-CM, wild-type transthyretin amyloid cardiomyopathy.

Table 3 Echocardiography

	Study inclusion (n=25)	12 months after study start (n=21)	P-value
IVS thickness (mm)	17 (13; 28)	18 (14; 25)	ns
LV Inferior wall thickness (mm)	16 (11; 24)	17 (12; 19)	ns
LV myocardial mass (g)	340 (173; 523)	335 (228; 501)	ns
LVEDD (mm)	44 (36; 53)	42 (33; 54)	ns
LVESD (mm)	33 (23; 45)	32 (24; 49)	ns
MAPSE (mm)	10 (5; 23)	8 (4; 13)	ns
TAPSE (mm)	14 (8; 23)	15 (2; 20)	ns
E/E’	11 (7; 28)	14 (4; 31)	ns

Note: Continuous data are expressed as median (range).

Abbreviations: E/E’, passive mitral inflow/lateral early diastolic mitral annular velocity; IVS, interventricular septum; LVEDD, left ventricular end-diastolic diameter; LVESD, left ventricular end-systolic diameter; MAPSE, mitral annular plane systolic excursion; ns, nonsignificant; TAPSE, tricuspid annular plane systolic excursion.

Table 4 Cardiac magnetic resonance imaging

	Study inclusion (n=14)	12 months after study start (n=14)	P-value
LVEF (%)	53 (33; 69)	54 (28; 71)	ns
EDV (mL)	161 (87; 278)	162 (102; 289)	ns
ESV (mL)	69 (40; 185)	76 (40; 207)	ns
LV myocardial mass (g)	196 (100; 247)	180 (85; 237)	0.03
MAPSE (mm)	7 (3; 10)	6 (3; 9)	ns
TAPSE (mm)	12 (4; 17)	11 (5; 16)	ns

Note: Continuous data are expressed as median (range).

Abbreviations: EDV, end-diastolic volume; ESV, end-systolic volume; LVEF, left ventricular ejection fraction; MAPSE, mitral annular plane systolic excursion; ns, nonsignificant; TAPSE, tricuspid annular plane systolic excursion.

Figure 3 cMRI findings.

Notes: LV myocardial mass (A) and LVEF (B) of individual patients with wtATTR-CM determined by cMRI before and after 12 months of green tea extract consumption.
Abbreviations: cMRI, cardiac magnetic resonance imaging; LV, left ventricular; LVEF, LV ejection fraction; t₀, baseline; t₁₂, at 12 months; wtATTR-CM, wild-type transthyretin amyloid cardiomyopathy.

Figure 4 LV myocardial mass (A) and LVEF (B) of patients with wtATTR-CM who underwent assessment by cMRI with green tea extract consumption for longer than 1 year.

Abbreviations: cMRI, cardiac magnetic resonance imaging; LV, left ventricular; LVEF, LV ejection fraction; t₀, baseline; t₁₂, at 12 months; t₁₇, at 17 months; t₂₅, at 25 months; t₃₀, at 30 months; t₄₄, at 44 months; wtATTR-CM, wild-type transthyretin amyloid cardiomyopathy.