Clinical Research Directory

Inclusion Criteria: 1. Antiretroviral therapy use for \>12 months 2. HIV Viral Load \<200 copies/mL 3. Left Ventricular Ejection Fraction\>50% 4. Demonstration of one or more criteria for myocardial dysfunction on cardiac transthoracic echocardiogram, relevant to the progression of heart failure with preserved ejection fraction: * Left Atrial Volume Index \> 28 mL/m2 * Global Longitudinal Strain \<18% * Left Ventricular Mass Index \> 95g/m2 (female), 115 g/m2 (male) Exclusion Criteria: 1. Known history of congestive heart failure or valvular disease 2. Recent cardiac event or stroke within 3 months 3. Current medication use acting along the renin-angiotensin-aldosterone-system (RAAS) pathway \[angiotensin-converting enzyme inhibitor (ACEi), angiotensin receptor blocker (ARB), mineralocorticoid receptor blockade, direct renin inhibitor), potassium (K) supplementation or diuretic 4. Angioedema to ACEi or ARB 5. Systolic blood pressure\<100 mmHg 6. Medication suspected to have contraindication with active study drug 7. Steroid use within last 3 months 8. Uncontrolled diabetes requiring insulin and/or hemoglobin A1c (HbA1c) \> 7.5% 9. Creatinine (Cr)\>1.5 mg/dL and estimated glomerular filtration rate (eGFR) \<60 mL/min/1.73m2 10. K\>5.5 mEq/L 11. Hemoglobin \<10.0 g/dL 12. Known liver disease or alanine transaminase (ALT)\>3x upper limit normal 13. Pregnant, actively seeking pregnancy or breastfeeding 14. Estrogen, progestin derivative, or other sex steroid use within 3 months. Stable physiologic testosterone replacement (\> 3 months) is acceptable 15. Current bacterial or other infection 16. Active substance abuse 17. Known reaction to gadolinium