Effect of oral probiotics on intestinal microecology in patients with chronic heart failure
Objective To investigate the effect of probiotics in patients with chronic heart failure(CHF)and its impact on intestinal microecology.Methods A total of 112 patients with CHF were selected as research subjects and randomly divided into study group and control group,with 56 pa-tients in each group.The control group received angiotensin-converting enzyme inhibitors(ACEI)combined with angiotensin Ⅱ receptor blockers(ARB)for treatment,while the study group received bifidobacterium viable capsules on the basis of treatment in the control group.The levels of myocardi-al fibrosis markers[type Ⅰ collagen precursor C-propeptide(PⅠ CP),type Ⅲ collagen precursor N-propeptide(PⅢNP),P Ⅰ CP/PⅢNP,type Ⅰ collagen carboxyl-terminal peptide(Ⅰ CTP)],cardiac function indicators[leftventricular ejection fraction(LVEF),left ventricular end-diastolic di-ameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular end-systolic vol-ume(LVESV)],intestinal flora abundance,plasma trimethylamine oxide(TMAO)levels,and ser-um tumor necrosis factor-α(TNF-α)and interleukin-1 β(IL-1β)levels were measured in both groups.The therapeutic effects,drug safety,re-hospitalization rate,and mortality rate within 3 months after discharge were observed in both groups.Results The total effective rate in the study group was 71.43%,which was higher than 51.79%in the control group(P<0.05).After treatment,the LVEF in the study group was higher than that in the control group,while LVEDD,LVESD,and LVESV were lower than those in the control group(P<0.05).After treatment,the P Ⅰ CP/PⅢNP in the study group was higher than that in the control group,while the Ⅰ CTP level was lower than that in the control group(P<0.05).After treatment,the abundances of Proteobacteria,Actinobac-teria,Firmicutes,and Fusobacteria in the study group were lower than those in the control group,while the abundance of Bacteroidetes was higher than that in the control group(P<0.05).After treatment,the levels of TMAO,TNF-α,and IL-1 β in the study group were lower than those in the control group(P<0.05).No serious adverse reactions occurred in either group after treatment.Within 3 months after discharge,the re-hospitalization rate in the study group was 12.50%,which was lower than 30.36%in the control group(P<0.05).The mortality rates in the study group and the control group were 1.79%and 7.14%,respectively,but no statistically significant difference was observed(P>0.05).Conclusion The combination of probiotics with ACEI and ARB can ef-fectively reduce myocardial fibrosis in patients with CHF and improve intestinal microecology and prognosis.