Administration of Mesenchymal Stem Cells in Patients With Chronic Ischemic Cardiomyopathy (MESAMI2)

Inclusion Criteria:

• Patient who signed the informed consent,
• Chronic stable ischemic cardiomyopathy for at least one month with a NYHA Class II-IVand/or -Angina pectoris CCS Class III or IV,
• Not a candidate for revascularization by coronary artery by-pass surgery orangioplasty,
• Left ventricular function ≤45%,
• Presence of ischemia or myocardial viability on the myocardial perfusion imaging,
• VO2 max≤ 20 ml/min/kg,
• Optimal medical therapy,
• Optimal interventional therapy (Implantable Cardiovertor Defibrillator, effortrehabilitation).

Exclusion criteria:

• Pregnancy or breastfeeding,
• Acute coronary syndrome or myocardial infarction during the last 3 months,
• Revascularization (PCI or CABG), or cardiac resynchronization during the last 3months,
• Further revascularization planned for the next 30 days,
• LVEF >45%,
• Left intraventricular Thrombus and / or ventricular aneurysm detected by transthoracicechocardiography,
• Wall thickness in the target region <8 mm as determined by echocardiography,
• Critical Limb Ischemia stages 3 or 4,
• Inability to achieve a VO2 test,
• Not feasible peripheral arterial access for percutaneous procedure,
• Aortic stenosis (<1cm²) or aortic insufficiency (> 2 +),
• Patients with transplanted organ,
• Chronic renal failure with creatinemia ≥ 250 µmol/L,
• Severe hepatic dysfunction,
• Chronic atrial fibrillation,
• Decompensated heart failure,
• Uncontrolled Ventricular arrhythmias,
• Indication of cardiac resynchronization by multisite pacemaker or cardiacresynchronization during the last 3 months,
• Obesity preventing bone marrow aspiration or manual compression of the puncture areaafter bone marrow collection,
• Active uncontrolled infection
• Immuno-modulator treatment (ciclosporin, mycophenolate, mycophenolate mofetil,azathioprine, tacrolimus, anthracyclines, neupogen, hydrea, etanercept interferons,prednisolone, methylprednisolone, colchicine),
• History of cancer in the last 5 years,
• Hemopathy, hematopoietic disease,
• Haemorrhagic syndrome,
• Chronic or progressive disease that may alter the prognosis within 3 months,
• Positive serologies for Human immunodeficiency virus (HIV1-2), HTLV-1 (human T-celllymphotrophic virus) and 2, HBV (hepatitis B virus) or HCV (hepatitis B virus).
• Allergic to xylocain.