Inclusion criteria: | |
• Patients with chronic heart failure and left ventricular ejection fraction ≤40% with coronary artery disease and with symptoms of heart failure in the NYHA class 3 on standard heart failure therapy for 3 months and in a stabilised state for at least 1 month, | |
• Age 40–80 years | |
• Informed, written consent by the patient | |
• Ability to comply fully with the study protocol | |
• Negative pregnancy test (and effective contraception) in women with childbearing potential | |
Exclusion criteria: | |
• Previous bone marrow disease (especially myelodysplastic syndrome or non-Hodgkin’s lymphoma) | |
• Repeated acute coronary syndrome <1 month | |
• CRT device with LV lead in CS | |
• Active infection or ATB treatment <1 week | |
• Previous malignant ventricular arrhythmias without ICD implantation | |
• Anemia (HTC ≤ 28%), leukocytosis (≥14.000/mm3) or thrombocytopenia (≤50.000/mm3) | |
• Previous bleeding diathesis | |
• Need for hematopoietic growth factor treatment (e.g. erythropoetin, G-CSF) | |
• Impossibility of aspiration 240 ml of bone marrow | |
• Hepathopathy or cirrhosis (bilirubin, ALT or AST ≥2,5x ULN) | |
• Chronic kidney disease >3b stage (eGFR <45 ml/min/1.73m2) | |
• Uncontrolled hypertension | |
• Need for high dose (> 7.5 mg/day) corticotherapy within the next 6 months | |
• Inability to stop anticoagulation therapy (> 72 h) before bone marrow aspiration | |
• Known malignancies requiring actino or chemotherapy, or previous actinotherapy | |
• Patients with a BMI > 40 | |
• Known allergy to contrast agents | |
• Other comorbidities with a life expectancy of 6 months |