Metoprolol XR in Heart Failure With Normal Ejection Fraction

Inclusion criteria

• Age 18 years and above of either sex
• Presence of New York Heart Association functional class II-IV of at least 4 weeks' duration
• LVEF ≥ 50% in a nondilated LV (LV end-diastolic volume < 97 ml/m2 measured by echocardiography)
• Echocardiographic evidence of LV diastolic dysfunction
• Willing to give written informed consent

Exclusion criteria

• Clinically unstable as defined by any change in diuretic dose in the month prior to enrolment.
• Significant valvular heart disease, pericardial disease, hypertrophic or restrictive cardiomyopathy
• Unstable angina or MI within the past 4 weeks.
• Alternative probable cause of the patient's symptoms (e.g.significant pulmonary disease);
• Any previous left ventricular ejection fraction below 40%
• Other systemic disease limiting life expectancy to less than 3 years
• Any contraindication to metoprolol use (heart rate less than 45 beats per minute, heart block greater than first-degree i.e. PR interval ≥ 0.24 second, systolic blood pressure <100 mm Hg, asthma)
• Conditions associated with alteration in serum levels of procollagen type I e.g. alcoholic liver disease, metabolic bone disease, hyperthyroidism
• Current participation (including prior 30 days) in any other therapeutic trial
• Any condition that, in the opinion of the investigator, may prevent the participant from adhering to the trial protocol