In the last years the paracrine factors of myocardial transplanted cells were discussed to represent the likeliest mechanism underlying cardiac regeneration. Previously, our group showed that intravenous administration of the secrteome of apoptotoc peripheral blood mononuclear cells (APOSEC) was effective in reducing infarction size and increasing left ventricular ejection fraction. The primary aims of this doctoral thesis were to (1) evaluate the regenerative effect of APOSEC in a translational model of chronic ischemic left ventricular (LV) dysfunction; (2) explore the cardioprotective effect of APOSEC using gene expression analysis in ischaemic cardiomyopathy (iCMP); and (3) validate the diagnostic value of a percutaneous intramyocardial navigation system that has been used for cell-based regeneration in iCMP, comparing it to a magnetic resonance imaging (MRI) approach (cardiac MRI; cMRI) with late enhancement (cMRI-LE). In the chronic model, APOSEC injection was associated with a decrease in infarct size, improved cardiac index, and improved myocardial viability compared to controls. We found that in areas exposed to APOSEC, apoptotic and inflammation-related genes were downregulated. RT-PCR confirmed downregulation of Caspase-1 and showed upreglutaion of Mef2c in APOSEC-treated animals. Genexpression changes 30 days after treatment demonstrate long-lasting effects of this cell-free paracrine factor therapy. Moreover, by combining unipolar with bipolar voltage maps of NOGA, the endocardial mapping was comparable to cMRI-LE for accurately characterizing the zone of interest for intramyocardial therapy. Thus we have demonstrated that cell-free therapy targeting regeneration for chronic ischemic LV dysfunction can be efficacious when applied intramyocardially via percutaneous injection by NOGA.