Patient description: An 82-year-old woman comes to the emergency department because of chest pain and shortness of breath after being awakened in the morning by stabbing substernal chest pain radiating to the left shoulder and jaw. The patient had hypertension, renal-artery stenosis with chronic renal insufficiency, hypercholesterolemia, osteoporosis and dementia. Blood pressure was 199/108 mm Hg, respiratory rate 18 bpm, oxygen saturation 98% on ambient air. The heart sounds were rapid and with no murmurs. CK-MB was 10.9 ng/ml, CK was 89 U/l, CK index was 12.2% and Troponin T was 0.40 ng/ml. An EKG showed sinus regular tachycardia of 119 bpm, with ST-segment elevations up to 3 mm in V1, V2, and V3. A chest radiograph showed low lung volumes and right basilar subsegmental atelectasis. Coronary angiography showed no stenosis or clinically significant disease. Left ventriculography revealed akinesis of the anterior wall, hypokinesis of the apical and distal inferior walls, and compensatory hyperkinesis of the basal anterior and basal inferior walls. A transthoracic echocardiogram showed severe segmental left ventricular dysfunction involving the septum, anteroseptal territory, and apex. The overall left ventricular systolic function was mildly impaired and there was mild mitral regurgitation.

Clinical trial eligibility criteria: eligible ages (years): 18.0-999.0,  Myocardial Infarction History of anterior MI within the prior 4 weeks to 12 months due to coronary artery atherosclerotic disease and evidenced by typical ischemic symptoms, serial ST-T changes (new ST elevation or new left bundle block) and elevated troponin or CK-MB >5 times the upper limit of normal with at least one of the following, based on standardly accepted definition of acute MI: development of pathological Q wave ECG changes, imaging evidence of new loss of viable myocardium, or new regional wall motion abnormalities History of percutaneous coronary intervention (PCI), with stent placement resulting in TIMI flow = 3, in the left anterior descending coronary artery supplying the infarcted, dysfunctional territory and through which the treatment will be infused At least one historical assessment of left ventricular ejection function (LVEF) ≤0.45 as determined by any one of the standard modalities (echocardiography, ventriculogram, nuclear imaging, CT and/or MRI). For subjects that fulfill the of Recent MI (i.e., within 90 days of MI) at time of screening visit: assessment must be post-reperfusion after index MI and be the most recent test prior to signing informed consent. For subjects that fulfill the of Chronic MI (i.e., greater than 90 days from MI) at time of screening visit: assessment must be at least 21 days post-reperfusion after index MI and the most recent test prior to signing informed consent. Note: subjects may screen as a Recent MI but be randomized into the Chronic MI strata if the infusion date is > 90 days post-MI Left ventricular infarct size of ≥ 15% of left ventricular mass as determined by screening MRI, with associated thinning and/or hypokinesis, akinesis, or dyskinesis, with no large aneurysmal area in the anterior/anterolateral/anteroseptal regions . In subjects with infarcts in >1 myocardial wall, >50% of the total LV scar should be in the anterior/anterolateral/anteroseptal regions No further revascularization clinically indicated at the time the subject is assessed for participation in the clinical trial Ability to provide informed consent and follow-up with protocol procedures Age ≥18 years  Subjects with a history of coronary artery bypass surgery, and a graft (left internal mammary artery or saphenous vein graft) attached to the left anterior descending coronary artery Diagnosed or suspected myocarditis History of cardiac tumor, or cardiac tumor demonstrated on screening MRI History of acute coronary syndrome in the 4 weeks prior to study infusion History of previous stem cell therapy History of radiation treatment to the central or left side of thorax Current or history (within the previous 5 years) of systematic auto-immune or connective tissue disease including, but not limited to, giant cell myocarditis, cardiac or systemic sarcoidosis, Dressler's syndrome, chronic, recurrent or persistent pericarditis History of or current treatment with immunosuppressive, anti-inflammatory, or other agents to treat manifestations of systemic immunologic reactions, including chronic systemic corticosteroids, biologic agents targeting the immune system, anti-tumor and anti-neoplastic drugs, anti-VEGF, or chemotherapeutic agents within 3 months prior to enrollment Prior of planned ICD and/or pacemaker placement Estimated glomerular filtration rate < 30 mL/min