Received: 15 March 2020 | Revised: 28 August 2020 | Accepted: 7 September 2020 DOI: 10.1002/med.21733 REVIEW ARTICLE Autophagy and cardiac diseases: Therapeutic potential of natural products Xiaoqian Wu 1 | Zumei Liu 2 | Xi‐Yong Yu 1 | Suowen Xu 3 | Jiandong Luo 1 1 Key Laboratory of Molecular Target and Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences and The Fifth Affiliated Hospital, Guangzhou Medical University, Guangzhou, China 2 Department of Central Laboratory, Guangdong Second Provincial General Hospital, Guangzhou, Guangdong, China 3 Department of Endocrinology and Metabolism, Division of Life Sciences and Medicine, The First Affiliated Hospital of USTC, University of Science and Technology of China, Hefei, China Correspondence Xi‐Yong Yu and Jiandong Luo, Key Laboratory of Molecular Clinical Pharmacology, Guangzhou Medical University, 1 Jingxiu Rd, 511436 Guangzhou, China. Email: yuxycn@aliyun.com (X.‐Y. Y.) and jiandongluo@hotmail.com (J. L.) Funding information Natural Science Foundation of Guangdong Province, Grant/Award Number: 2015A030313476; National Natural Science Foundation of China, Grant/Award Numbers: 81573429, U1601227, 81573433 Abstract The global incidence of cardiac diseases is expected to increase in the coming years, imposing a substantial socioeconomic burden on healthcare systems. Autophagy is a tightly regulated lysosomal degradation mechanism important for cell survival, homeostasis, and function. Accumulating pieces of evidence have indicated a major role of autophagy in the regulation of cardiac homeostasis and function. It is well established that dysregulation of autophagy in cardiomyocytes is involved in cardiac hypertrophy, myocardial infarction, diabetic cardiomyo- pathy, and heart failure. In this sense, autophagy seems to be an attractive therapeutic target for cardiac diseases. Recently, multiple natural products/phytochemicals, such as resveratrol, berberine, and curcumin have been shown to regulate cardiomyocyte autophagy via different path- ways. The autophagy‐modifying capacity of these com- pounds should be taken into consideration for designing novel therapeutic agents. This review focuses on the role of autophagy in various cardiac diseases and the pharma- cological basis and therapeutic potential of reported nat- ural products in cardiac diseases by modifying autophagic processes. KEYWORDS autophagy, autophagy flux, cardiac diseases, natural products, therapeutics Med Res Rev. 2020;1–28. wileyonlinelibrary.com/journal/med © 2020 Wiley Periodicals LLC | 1 Xiaoqian Wu and Zumei Liu contributed equally to this study. Xi‐Yong Yu, Suowen Xu, and Jiandong Luo are co‐senior authors.