Retrograde Application of Bone Marrow Aspirate Concentrate

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 ≥18 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) * Acute myocardial infarction ˂ 1 week * Active infection or antibiotics treatment ˂ 1 week * Previous malingant ventricular arrhythmias without cardioverter-defibrilator (ICD) implantation * Anemia (HTC≤28%), leukocythosis (≥ 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 240ml of bone marrow * Hepathopathy or cirrhosis (bilirubin, ALT or AST ≥ 2,5x upper limit of normal) * Terminal renal insufficiency or haemodyalysis * Uncontrolled hypertension * Need for high dose (\> 7.5mg/day) corticotherapy within the next 6 months * Inability to stop anticoagulation therapy (\>72 hours) 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