The purpose of this study is to determine whether renal sympathetic denervation (RSD)(a treatment that lowers the activity of the sympathetic nervous system) is useful in the management of patients with heart failure with preserved ejection fraction (HF-PEF).

Increasing evidence suggests an important role of activation of the sympathetic nervous system (SNS) in heart failure with preserved left ventricular ejection fraction. The current study aims to evaluate efficacy of renal sympathetic denervation for the modulation of the SNS in patients with HF-PEF.

Inclusion Criteria:

• EF>40%
• NHYA 2-3
• Evidence of HF-PEF (mixture of dilated left atrium, left ventricular hypertrophy, raised E/E', elevated LVEDP/PCWP, raised BNP)

Exclusion Criteria:

• Previously documented EF<40%
• Hypertrophic, restrictive, dilated cardiomyopathy
• Significant valvular heart disease
• Unfavourable renal artery anatomy for renal denervation
• eGFR<45
• Contraindication to MRI
• Myocardial infarction, unstable angina or cerebrovascular accident in last 3 months