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