Inclusion Criteria:

- age >21 years

- of either sex

- the patient is willing and capable of complying with the requirements of this
protocol

- the patient has provided written informed consent

- the patient has clinical evidence of chronic heart failure:

- reduced ejection fraction (≤40%) or left ventricular impairment on
echocardiography (LVEDD ≥60mm)

- stable clinical condition and medication for at least 1 month prior to the study
(New York Heart Association class II-IV).

- the patient is receiving appropriate conventional medical therapy for heart
failure (ACE inhibitor or angiotensin II blocker, diuretics, beta-blocker as
indicated and tolerated).

Exclusion Criteria:

- congenital heart disease

- any life-threatening disease, other than heart failure

- active malignancy of any type, or history of a malignancy within previous 5 years.
Patients with a history of other malignancies that have been surgically removed and
who have no evidence of recurrence for at least five years prior to study enrolment
are acceptable.

- previous heart transplant

- severe neuro-muscular disease

- history of unstable angina, myocardial infarction or stroke within 3 months prior to
the study

- pregnancy or women of child-bearing age

- treatment with immunosuppressive therapy e.g. steroids for rheumatoid arthritis or
obstructive lung disease

- significant renal dysfunction (serum creatinine >250mmol/l), severe liver disease
(liver function tests > 3 times normal)

- unable to understand and comply with protocol or to give informed consent