Transplantation of human cardiomyoblast-like cells (hCLCs) from human adipose 
tissue-derived multi-lineage progenitor cells improved left ventricular function 
and survival of rats with myocardial infarction. Here we examined the effect of 
intracoronary artery transplantation of human CLCs in a swine model of chronic 
heart failure. Twenty-four pigs underwent balloon-occlusion of the first 
diagonal branch followed by reperfusion, with a second balloon-occlusion of the 
left ascending coronary artery 1 week later followed by reperfusion. Four weeks 
after the second occlusion/reperfusion, 17 of the 18 surviving animals with 
severe chronic MI (ejection fraction <35% by echocardiography) were 
immunosuppressed then randomly assigned to receive either intracoronary artery 
transplantation of hCLCs hADMPCs or placebo lactic Ringer's solution with 
heparin. Intracoronary artery transplantation was followed by the distribution 
of DiI-stained hCLCs into the scarred myocardial milieu. Echocardiography at 
post-transplant days 4 and 8 weeks showed rescue and maintenance of cardiac 
function in the hCLCs transplanted group, but not in the control animals, 
indicating myocardial functional recovery by hCLCs intracoronary 
transplantation. At 8 week post-transplantation, 7 of 8 hCLCs transplanted 
animals were still alive compared with only 1 of the 5 control (p=0.0147). 
Histological studies at week 12 post-transplantation demonstrated engraftment of 
the pre DiI-stained hCLCs into the scarred myocardium and their expression of 
human specific alpha-cardiac actin. Human alpha cardiac actin-positive cells 
also expressed cardiac nuclear factors; nkx2.5 and GATA-4. Our results suggest 
that intracoronary artery transplantation of hCLCs is a potentially effective 
therapeutic strategy for future cardiac tissue regeneration.