Vericiguat in Patients With Coronary Microvascular Dysfunction Causing Stable Chest Pain (V-COM)

Inclusion Criteria: 1. Stable recurrent chest pain. 2. 40 to 75 years old. 3. Have coronary computed tomography (CT) angiogram or catheter coronary angiogram within 6 months showing non-obstructive coronary artery disease (\<50% coronary artery stenosis or fractional flow reserve \>0.8). 4. Stress CMR MPR \<2.19 12 or Stress MBF \<2.19ml/g/min 13. 5. Female participant is eligible to participate if she is not pregnant or breastfeeding, is not a woman of childbearing potential (WOCBP),or is a WOCBP and agrees to follow contraceptive guidance during the study intervention period and for at least 1 month after the last dose of study intervention. Exclusion Criteria: 1. Systolic blood pressure \<100 mm Hg. 2. Concurrent use of soluble guanylate cyclase stimulators (eg. Riociguat), or phosphodiesterase type 5 inhibitors (eg. vardenafil, tadalafil, and sildenafil). 3. Has known allergy or sensitivity to any soluble guanylate cyclase stimulator. 4. On long-acting nitrates (eg. isosorbide mononitrate) 5. Known cardiomyopathy, complex congenital heart disease, endocarditis or pericarditis. 6. Has acute coronary syndrome (unstable angina, non-ST elevation myocardial infarction (NSTEMI), or ST elevation myocardial infarction (STEMI)) or coronary revascularization (coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI)) within 60 days prior to randomisation, or indication for coronary revascularization at time of randomisation. 7. Has symptomatic carotid stenosis, transient ischemic attack (TIA) or stroke within 60 days prior to randomisation. 8. Estimated glomerular filtration rate (eGFR) \<30 mL/min/1.73m2 9. Malignancy or other non-cardiac condition limiting life expectancy to \<3 years. 10. Patient's with implanted devices which are not MRI compatible.