Inclusion criteria:
Age range from 30 to 70 years
Patients with systolic heart failure (LVEF <40%) approved by a cardiologist and receiving at least 3 months of standard heart failure treatment , Medications have reached the maximum tolerated dose and their medication dose will remain constant throughout the study.
class 1,2 and 3 of NYHA classification
Willingness to participate in the study and sign informed written consent
Lack of other diseases including chronic and acute liver disorders (hepatitis B, C, etc.), diabetes, thyroid disorders, severe renal dysfunction (300 mmol /l ≤ creatinine ), pulmonary diseases, inflammatory and autoimmune diseases, Cancer, acute infection
Not using any nutritional supplements for the past two months.
No substance abuse and smoking
Not taking Corticosteroids in the past 4 weeks
Failure to receive antibiotics in the past 3 months
No history of gastrointestinal surgery
No anti-inflammatory drugs except low-dose aspirin (one 80 mg daily)
No artificial heart valve
No history of rheumatic heart disease
Not being pregnant and breastfeeding
Lack of insulin
BMI< 30
Exclusion criteria:
Not willing to continue cooperation
use of less than 80% of supplements given to the patient during the study period Acceptance rate = The number of capsules given to the patient - the Number of capsules not used / The number of capsules given to the patient
other disease such as metabolic diseases,Cancer and inflammatory diseases during the study that Need special treatment or antibiotic use.
Changes in the type and dose of drug which is using by the patient .