Researchers at King’s College London have discovered that a compound naturally produced in the body after eating pomegranates, walnuts, and certain berries could significantly improve heart function in a type of heart failure with limited treatment options. In a study published in Science Advances, the team reported that urolithin A can improve the heart’s ability to relax between beats, reduce scarring, and prevent heart enlargement.
About 50% of people with heart failure have a heart that can still pump normally but becomes stiff and loses its ability to relax, limiting how much blood it can fill with. Known as heart failure with preserved ejection fraction (HFpEF), this condition can cause breathlessness, fatigue, and reduced ability to exercise.
“This type of heart failure remains one of the most challenging forms of heart disease to treat,” said Joseph Burgoyne, PhD, senior lecturer at King’s College London and senior author of the study. “Despite its growing burden, treatment options remain limited because the disease is complex and varies considerably between patients.”
In recent years, urolithin A has attracted growing interest because of its links to healthy aging and mitochondrial function. Our bodies naturally produce urolithin A when gut microbes break down ellagitannins, a group of compounds found in pomegranates and walnuts. However, not everyone produces the same amount of urolithin A, largely because of differences in gut microbiome composition.
Burgoyne and colleagues found that urolithin A activates the PKGIα protein, which plays an important role in maintaining blood vessel function and helping the heart muscle relax. In animal models, treatment with urolithin A improved measures of heart function by up to 80% compared with controls. The compound was able to reduce fibrosis and improve the ability of heart tissue to relax, while preventing heart muscle cells from becoming enlarged.
Similar results were seen in engineered human heart tissue closely mimicking the structure and function of human heart muscle, with urolithin A treatment significantly improving tissue relaxation.
“Our findings identify a completely new therapeutic target and show that urolithin A can activate this pathway to improve heart relaxation and reduce disease severity,” said Burgoyne. “This raises the exciting possibility of developing new treatments that improve clinical outcomes and quality of life for people living with the condition.”
Urolithin A has already been evaluated in clinical trials, where it showed a favorable safety profile. This could make it a promising candidate for further research and translation into a potential treatment for HFpEF, addressing a significant and long-standing challenge in cardiovascular medicine.
“This type of heart failure is becoming increasingly common as populations age and rates of obesity and diabetes rise,” said Burgoyne. “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.”
