Probiotics Supplementation on Cardiac Remodeling Following Myocardial Infarction: a Single-Center Double-Blind Clinical Study

Jul 19, 2020Journal of cardiovascular translational research

Probiotics and heart muscle changes after a heart attack: a controlled clinical study

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Abstract

Probiotics supplementation resulted in significant decreases in serum TGF-β concentrations by 8.0 ± 2.1 pg/mL and TMAO levels by -17.43 ± 10.20 mmol/L in patients with myocardial infarction.

Adverse cardiac remodeling (CR) can occur after myocardial infarction (MI) and is associated with heart failure (HF).
The trial involved 44 subjects with MI undergoing percutaneous coronary intervention (PCI), receiving either probiotics or a placebo.
Significant decreases in TGF-β and TMAO levels were observed in the probiotics group compared to the placebo group.
No significant changes were noted in MMP-9 and procollagen III levels after probiotics supplementation.
While improvements in echocardiographic indices were greater in the probiotics group, these were not statistically significant.
Regression analysis indicated that baseline left ventricular ejection fraction and changes in procollagen III could predict 62% of final left ventricular ejection fraction levels.

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Adverse cardiac remodeling after myocardial infarction (MI) can lead to the syndrome of heart failure (HF). Recently, changes in gut microbiota composition (dysbiosis) have appeared as a novel candidate that may be linked to the development of CR and HF. The aim of this trial was to evaluate the effects of probiotics administration on attenuating CR in patients with MI. A single-center double-blind placebo-controlled stratified randomized clinical study was conducted in 44 subjects with MI who underwent percutaneous coronary intervention (PCI). Patients were randomly assigned to take, with lunch, either a probiotic capsule containing 1.6 × 10colony-forming unit (CFU) of bacteria (treatment group) or capsules contained inulin (control group) over 3 months. CR biomarkers (including serum procollagen III, transforming growth factor beta (TGF-β), trimethylamine N-oxide (TMAO), and matrix metallopeptidase 9 (MMP-9)) were assessed. Echocardiography results were measured at baseline and after the intervention. Significant decreases were seen in serum TGF-β concentrations (- 8.0 ± 2.1 vs. - 4.01 ± 1.8 pg/mL, p = 0.001) and TMAO levels (- 17.43 ± 10.20 vs. - 4.54 ± 8.7 mmol/L, p = 0.043), and there were no differences were seen in MMP-9 (- 4.1 ± 0.12 vs. - 4.01 + 0.15 nmol/mL, p = 0.443) and procollagen III levels (- 1.35 ± 0.70 vs. 0.01 + 0.3 mg/L, p = 0.392) subsequent to probiotics supplementation compared with the placebo group. Improvements in echocardiographic indices were also greater in the probiotics group as compared with that in the control group, but not at a significant level. Regression analysis revealed that baseline left ventricular ejection fraction (LVEF), and changes of procollagen III, predicted 62% of the final LVEF levels. Probiotics administration may have a beneficial effect on the cardiac remodeling process in patients with myocardial infarction. Iranian Registry of Clinical Trials (IRCT): IRCT20121028011288N15. 9

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Probiotics Supplementation on Cardiac Remodeling Following Myocardial Infarction: a Single-Center Double-Blind Clinical Study

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