Pilot Study Lp299v Supplementation in Chronic Heart Failure

Eligibility Criteria

• * Age between 21-89 years old
• * Clinical diagnosis of Congestive Heart Failure (CHF) in the six months prior to enrollment along with an echocardiogram documenting systolic dysfunction with ejection fraction ≤40%
• * Clinical diagnosis of CHF in the six months prior to enrollment along with an echocardiogram documenting diastolic dysfunction with an ejection fraction ≥50%, and a H2FpEFF score of ≥6
• * New York Heart Association (NYHA) Class II-IIID heart failure symptoms with either ischemic or non-ischemic etiology OR similar diagnosis with congestive heart failure (CHF) along with an echocardiogram documenting an LV ejection fraction of 50% or more with similar NYHA classification as those with LVEF of 40% or less
• * Evidence of systemic inflammation at baseline (C-reactive protein ≥ 2 mg/L at the time of screening)
• * Heart failure due to severe valve disease such as Aortic Stenosis, Mitral Regurgitation, or Mitral Stenosis
• * Cancer besides non-melanoma skin carcinomas or localized prostate and breast cancer at the time of enrollment with life expectancy \<1 year
• * Lung disease such as Chronic Obstructive Pulmonary Disease (COPD), emphysema, or Pulmonary fibrosis
• * Active inflammatory disease or infectious disease at the time of enrollment
• * Current treatment (or use within the past 14 days) of steroids or anti-inflammatory treatments (excluding non-steroidal anti-inflammatory medications or steroids used solely for IV contrast dye allergy)
• * Chronic Kidney Disease with eGFR ≤ 30 mL/min
• * Hepatic Failure (Child's Class B or C)
• * Patients with Gastrointestinal (GI) tract illness such as short gut syndrome, inflammatory bowel disease, or an ileostomy, such that probiotic absorption would be altered
• * Anticipated need for cardiac surgery during the projected study period for the subject
• * Pregnancy
• * Patients who are receiving Vitamin K antagonists such as Coumadin or Warfarin
• * Neutropenia (Absolute Neutrophil Count (ANC) \< 1800/mm3)
• * Inability to give informed consent or follow the study protocol
• * On antibiotics at the time of enrollment or within one month of enrollment
• * Currently taking a Lactobacillus based probiotic as an outpatient at the time of enrollment
• * Patients who are unable to walk on treadmill or use a bicycle to participate in exercise testing
• * Allergy to Lp299v probiotic supplement