- Researchers believe 50% of all heart failure cases are heart failure with preserved ejection fraction (HFpEF).
- Current treatment for HFpEF includes medications and healthy lifestyle choices, such as following a heart-healthy diet.
- A new study found that a natural compound created in the gut microbiome after eating plant foods containing a certain type of polyphenol may help improve heart function in people with HFpEF, via animal and human tissue models.
Researchers estimate that about 64 million people around the world receive a diagnosis of heart failure — a cardiovascular condition where the heart is not able to efficiently pump blood.
It can lead to fluid retention and cause fatigue and shortness of breath when blood is not able to flow throughout the body.
Now, a new study published in the journal Science Advances has found, via animal and human tissue models, that a natural compound created in the gut microbiome when an individual eats plant foods containing a type of polyphenols called ellagitannins, may help improve heart function in people with HFpEF.
For this study, researchers used both an animal model and engineered human heart tissue created from human stem cells to test how the natural compound urolithin A might impact HFpEF.
“HFpEF is very common, and the number of people affected continues to rise,” Joseph Burgoyne, PhD, reader in cardiovascular biology within the School of Cardiovascular and Metabolic Medicine & Sciences at King’s College London, and senior author of this study, told Medical News Today.
“Although treatment options have improved, they remain limited and do not directly address some of the underlying problems, such as increased stiffness of the heart and its impaired ability to relax. There is therefore an important need to develop new therapies that target these mechanisms more directly,” Burgoyne continued.
“We screened natural compounds to identify molecules that could target a protein called PKG1alpha, which plays an important role in helping the heart muscle relax. Through this screening process, we identified urolithin A, a compound produced by the body following the consumption of foods such as pomegranates, walnuts, and some berries.”
— Joseph Burgoyne, PhD
At the study’s conclusion, scientists found that animal models of HFpEF treated with urolithin A experienced improved heart function as much as 80%, when compared to non-treated animal models.
Via the human heart tissue model created from human stem cells, researchers reported urolithin A helped to significantly improve tissue relaxation in the cells.
“In our animal model of HFpEF, urolithin A was highly effective at reducing several markers of heart dysfunction, including improving the heart’s ability to relax and reducing stiffness,” Burgoyne said. “These findings provide evidence that targeting PKG1alpha could be an effective new strategy for treating HFpEF.”
“They also suggest that urolithin A, or drugs designed to work in a similar but potentially more potent way, could provide a basis for developing new treatments,” he continued. “Further research will be needed to determine whether these benefits translate to patients.”
MNT spoke with Kevin Shah, MD, a board-certified cardiologist and Program Director of Heart Failure Outreach at MemorialCare Heart & Vascular Institute at Long Beach Medical Center in Long Beach, CA, who commented that this is an exciting and interesting study as it identifies a new potential treatment target for HFpEF.
“The findings are encouraging since they were supported in both animal models and engineered human heart tissue,” Shah, who was not involved in this study, said. “We do need clinical studies to translate this to patients.”
“HFpEF accounts for approximately half of heart failure cases,” he continued. “We are gaining momentum on current treatment options, but the treatment likely needs to be refined based on subtypes, e.g. driven by high blood pressure versus driven by kidney disease. Some patients still struggle and have poor quality of life, so identification of new pathways could lead to more effective treatments.”
“The next step is to determine whether these preclinical findings can be replicated in patients,” Shah added. “Longer-term studies and clinical trials to improve symptoms, exercise capacity, and quality of life in patients with HFpEF would be encouraging.”
In a press release, Burgoyne said: “While there isn’t enough evidence to suggest that people should eat pomegranates to treat heart failure, these findings raise the possibility that dietary approaches that enhance urolithin A production may help alleviate this condition.”
Monique Richard, MS, RDN, LDN, FAND, IFNCP, a registered dietitian nutritionist and owner of Nutrition-In-Sight, told MNT that this study’s findings are an intriguing and affirming example of how the gut, diet, and cardiovascular system may be connected in ways we are only beginning to understand.
“Urolithin A is particularly interesting because it is not simply a nutrient we eat by itself, but a metabolite produced by our gut microbiota from compounds such as ellagitannins, found in certain plant foods that can serve as precursors,” Richard, who was not involved in this study, explained.
“This isn’t really a story about eating more urolithin A; it’s a story about what happens when high quality plant food interacts with our microbiome,” she added.
“What’s exciting to me is that this research blurs the line between nutrition for the gut and nutrition for the heart,” Richard continued. “The gut isn’t simply where digestion happens, but a metabolic organ capable of transforming compounds from our food into signaling molecules that interact with the rest of the body.”
For those who wish to add more urolithin A in their diet, Richard said that we want to think about urolithin A not as a single compound treatment, but as a component in foods we want more of, that provide its precursors.
Richard said ellagitannins — a type of polyphenol — and related compounds are found in:
Richard said a practical goal is to incorporate these foods regularly in a dietary pattern rich in whole foods rather than treating pomegranate as a “medicine” or “superfood.”
She suggested trying to add:
- berries to oatmeal or yogurt
- pomegranate arils to a grain bowl or fruit salad
- walnuts to a salad
- or having 4 ounces of pomegranate juice by itself, in herbal iced tea, or as refreshing ice cubes.
“Keep in mind that direct supplementation is very different from eating a pomegranate, and individual production from food varies considerably according to the gut microbiome,” Richard explained. “Food is packaged along with fiber, polyphenols, and additional micronutrients that support vascular health, cardiac function, and may assist in prevention of heart disease.”
“Sometimes the intervention is remarkably unglamorous: Eat a diverse range of plants consistently, feed the microbiome, move your body, get quality sleep, take prescribed medications as directed, and let emerging science help us understand why those fundamentals may be so effective,” she advised.
