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Evidence-Based Supplement Research
Evidence-Based Supplement Research

Effects of probiotics on heart failure: a systematic review and meta-analysis.

  • 2025-12-05
  • Frontiers in nutrition 12
    • Zheqin Zhu
    • Aoli Chen
    • Min Wang
    • Huimin Zhang
    • Sisi Dai
    • Rongzhen Liu
    • Jianhe Liu

Study Design

Type
Systematic Review
Population
patients with HF
Methods
systematic review and meta-analysis of 11 studies, searched eight major academic databases, used Review Manager 5.4 and Stata 18

Background

Heart failure (HF) is a serious clinical syndrome with substantial health threats. Emerging studies link intestinal flora dysbiosis to HF onset and progression. Although probiotics are thought to regulate gut microbiota, the specific impact of probiotics on HF remains unclear, highlighting the need for systematic evaluation.

Methods

As of 9 September 2025, we searched eight major academic databases using a predefined protocol for data extraction and quality assessment. Subsequently, a meta-analysis was conducted using Review Manager 5.4 and Stata 18. Forest plots were used to analyse the effect size, and publication bias was evaluated through funnel plots.

Results

Ultimately, 11 of the studies met the inclusion criteria for the systematic review. The results showed that probiotics have a slight beneficial effect on cardiac function indicators (LVEF, LVESV), reduced the levels of inflammatory factors (hs-CRP, IL-6, TNF-α), regulated the proportion of dominant gut bacteria, and decreased the readmission rates of patients with HF. However, no beneficial effects were found on NT-proBNP, activity endurance, TMAO, and mortality.

Conclusion

Probiotics exert cardioprotective effects and can serve as adjunctive therapy for HF management. Future high-quality, large-sample clinical studies are needed to further clarify their long-term efficacy and optimal intervention strategies.

Systematic review registration

Details of the protocol for this systematic review were registered on PROSPERO (CRD420251083960).

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