<h4>Background</h4>In recent years, there has been a positive attitude toward gut microbiota and its effect on cardiovascular diseases, including heart failure.<h4>Objective</h4>The purpose of this study was to evaluate the effect of synbiotics on left ventricular hypertrophy by measuring NT-proBNP, and their effect on blood pressure and hsCRP as an inflammatory biomarker in patients with chronic heart failure.<h4>Design</h4>In this triple-blind randomized clinical trial, 90 eligible patients were included in the study. Here, NPPB is linked to congestive heart failure.