Berries and Their Polyphenols as a Potential Therapy for Coronary Microvascular Dysfunction: A Mini-Review

• Type of Material: Article
• Authors: Rami S. Najjar, Georgia State University; Arielle M. Schwartz, Emory University; Brett J. Wong, Georgia State University; Puja Mehta, Emory University; Rafaela G. Feresin, Georgia State University
• Language: English
• Date: 2021-04-01
• Publisher: MDPI
• Publication Version: Final Published Version
• Copyright Statement: © 2021 by the authors. Licensee MDPI, Basel, Switzerland.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.3390/ijms22073373
• Title of Journal or Parent Work: International Journal of Molecular Sciences
• Volume: 22
• Issue: 7
• Grant/Funding Information: Developmental grant on Specialized Center of Research Excellence in Sex Differences (SCORE) from the NIH (1U54AG062334-01), K23HL105787, and Marcia Taylor (P.K.M.).; This work is supported in part by the Agriculture and Food Research Initiative [grant no. 2019-67017-29257/project accession no. 1018642] from the USDA National Institute of Food and Agriculture (R.G.F.)
• Keywords: Biochemistry & Molecular Biology; Physical Sciences; inflammation; Chemistry; microvascular; angiotensin; oxidative stress; polyphenols; endothelial dysfunction; berries; Science & Technology; adrenergic; ischemic heart disease; Life Sciences & Biomedicine; Chemistry, Multidisciplinary
• Research Categories: Health Sciences, Nutrition; Health Sciences, Public Health; Health Sciences, Rehabilitation and Therapy

Abstract

Ischemia with no obstructive coronary artery disease (INOCA) is a common diagnosis with a higher prevalence in women compared to men. Despite the absence of obstructive coronary artery disease and no structural heart disease, INOCA is associated with major adverse cardiovascular outcomes as well a significant contributor to angina and related disability. A major feature of INOCA is coronary microvascular dysfunction (CMD), which can be detected by non-invasive imaging and invasive coronary physiology assessments in humans. CMD is associated with epicardial endothelial-dependent and-independent dysfunction, diffuse atherosclerosis, and left-ventricular hypertrophy, all of which lead to insufficient blood flow to the myocardium. Inflammatory and oxidative stress signaling, upregulation of the renin-angiotensin-aldosterone system and adrenergic receptor signaling are major drivers of CMD. Treatment of CMD centers around addressing cardiovascular risk factors; however, there are limited treatment options for those who do not respond to traditional anti-anginal therapies. In this review, we highlight the ability of berry-derived polyphenols to modulate those pathways. The evidence supports the need for future clinical trials to investigate the effectiveness of berries and their polyphenols in the treatment of CMD in INOCA patients.