SYSTEMATIC REVIEW article
Front. Nutr.
Sec. Nutrition and Microbes
Effects of probiotics on heart failure: A systematic review and meta-analysis
Provisionally accepted
- 1The First Hospital of Hunan University of Chinese Medicine, Changsha, China
- 2Shanghai PuTuo District Center Hospital, Shanghai, China
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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.
Keywords: Meta-analysis, Heart Failure, Probiotics, cardiac function, adjuvant therapy
Received: 22 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Zheqin, Aoli, Wang, Zhang, 戴, Liu and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jianhe Liu, ljhtcm1@163.com
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