A 58-year-old man with a 3-year history of dilated cardiomyopathy (ejection fraction 28%) and NYHA Class III heart failure is on lisinopril 10 mg daily and metoprolol 50 mg twice daily. His current BP is 110/70 mmHg, HR 68/min, and serum creatinine 1.1 mg/dL. Echocardiography shows no improvement over the past 6 months. What is the most appropriate next step in management?

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