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dc.contributor.authorAwoyemi, Ayodeji Olawale
dc.contributor.authorMayerhofer, Cristiane
dc.contributor.authorFelix, Alex S.
dc.contributor.authorHov, Johannes Espolin Roksund
dc.contributor.authorMoscavitch, Samuel D.
dc.contributor.authorLappegård, Knut Tore
dc.contributor.authorHovland, Anders
dc.contributor.authorHalvorsen, Sigrun
dc.contributor.authorHalvorsen, Bente
dc.contributor.authorGregersen, Ida
dc.contributor.authorSvardal, Asbjørn M.
dc.contributor.authorBerge, Rolf Kristian
dc.contributor.authorHansen, Simen Hyll
dc.contributor.authorGötz, Alexandra
dc.contributor.authorHolm, Kristian
dc.contributor.authorAukrust, Pål
dc.contributor.authorÅkra, Sissel
dc.contributor.authorSeljeflot, Ingebjørg
dc.contributor.authorSolheim, Svein
dc.contributor.authorLorenzo, Andrea
dc.contributor.authorGullestad, Lars
dc.contributor.authorTrøseid, Marius
dc.contributor.authorBroch, Kaspar
dc.description.abstractBackground The gut microbiota represents a potential treatment target in heart failure (HF) through microbial metabolites such as trimethylamine N-oxide (TMAO) and systemic inflammation. Treatment with the probiotic yeast Saccharomyces boulardii have been suggested to improve left ventricular ejection fraction (LVEF). Methods In a multicentre, prospective randomized open label, blinded end-point trial, we randomized patients with LVEF <40% and New York Heart Association functional class II or III, despite optimal medical therapy, to treatment (1:1:1) with the probiotic yeast Saccharomyces boulardii, the antibiotic rifaximin, or standard of care (SoC) only. The primary endpoint, the baseline-adjusted LVEF at three months, was assessed in an intention-to-treat analysis. Findings We enrolled a total of 151 patients. After three months’ treatment, the LVEF did not differ significantly between the SoC arm and the rifaximin arm (mean difference was -1•2 percentage points; 95% CI -3•2 - 0•7; p=0•22) or between the SoC arm and the Saccharomyces boulardii arm (mean difference -0•2 percentage points; 95% CI -2•2 - 1•9; p=0•87). We observed no significant between-group differences in changes in microbiota diversity, TMAO, or C-reactive protein. Interpretation Three months’ treatment with Saccharomyces boulardii or rifaximin on top of SoC had no significant effect on LVEF, microbiota diversity, or the measured biomarkers in our population with HF.en_US
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleRifaximin or Saccharomyces boulardii in heart failure with reduced ejection fraction: Results from the randomized GutHeart trialen_US
dc.typeJournal articleen_US
dc.typePeer revieweden_US
dc.rights.holderCopyright 2021 The Authorsen_US
dc.identifier.citationEBioMedicine. 2021, 70, 103511.en_US

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