Clinical Research Directory

Rul-in Phase Inclusion Criteria: * Non obstructive stable coronary artery disease (CAD) on invasive coronary angiography (defined as the absence of either \>50% angiographic stenosis or any flow limiting lesion on functional evaluation) * Suspected diagnosis of difficult to control/ resistant hypertension for which renal denervation by radiofrequency ablation with Spyral Symplicity 3 could be considered. Rule-in Phase Exclusion Criteria: * Initiation of either nitrates, beta-blocker or calcium channel blocker less than 30 days before the end of the rule-in phase * Physiological assessment performed during first medical contact documenting preserved coronary microvascular function * Physiological assessment performed at the "first contact" hospitalization followed by modification of medical therapy during the rule-in phase, before RDN * Acceptable blood pressure control after medical treatment optimization * Identification of secondary causes of hypertension * Renal artery anatomy not suitable for RDN * Ejection fraction below 30% * Life expectancy below 1 year * Indication to cardiac surgery * Adenosine allergy * Pregnancy * Large necrotic area documented by either MRI, SPECT or combination of ECG signs + Echocardiographic images. * Hemodynamic instability * Refuse to sign informed consent * Age below 18 or above 80 Study Phase Inclusion Criteria: * Having coronary microvascular dysfunction documented by invasive functional assessment (IMR\>25 and or CFR \< 2) * Fulfilling all the rule-in phase inclusion criteria without any rule-in phase exclusion criteria Study Phase Exclusion Criteria: * Refuse to sign informed consent * Evidence of newly detected obstructive CAD on invasive coronary angiography performed 6 months after RDN