Direct Endomyocardial Injection of Autologous Bone Marrow Cells to Treat Ischaemic Heart Failure

Inclusion Criteria: * Age 18-80 years old * Canadian cardiovascular (CV) Class II-IV angina and/or NYHA class II-III HF symptoms * Received stable and "best" cardiac medical therapy including long-acting nitrates, beta-blocker, and angiotensin-converting enzyme inhibitors without control of symptoms. * Not suitable for conventional revascularization by their referring cardiologist. * LVEF \<40% by echocardiography. * Recent coronary angiogram (within the last 6 months) to document the coronary anatomy and insure the presence of CAD that is not amenable to standard revascularization procedures. * creatinine less than 250mmol/L, normal liver function, and normal blood count: WBC, granulocytes; platelet count, Hb. * Reversible perfusion defect on single photon emission computed tomography (SPECT) * Able to walk on treadmill * Hemodynamically stable * Subject is willing to comply with specified follow-up evaluations. * All patients give written informed consent. Exclusion Criteria: * Atrial fibrillation * History of syncope or major ventricular arrhythmias such as sustained ventricular tachycardia or ventricular fibrillation * Severe valve disease * Aortic or mitral valve prosthesis * History of cancer in last 5 years * Acute or chronic active sepsis, including HIV positive; hepatitis B or C positive * Left ventricular wall thickness less than 8 mm in the target territory * Left ventricular thrombus and/or spontaneous echo-contrast in the LV detected by echocardiography or LV aneurysm * Severe aorto-femoral-iliac disease * Recent heart attack within the last 30 days * Hypertrophic or restrictive cardiomyopathy * Severe co-morbidity associated with a reduction in life expectancy of less than 1 year