Amat-Santos, Ignacio JCatalá, PabloDiez Del Hoyo, FelipeFernandez-Diaz, Jose AAlonso-Briales, Juan HDel Trigo, MaríaRegueiro, AnderJuan-Salvadores, PabloSerra, VicençGutierrez-Ibanes, EnriqueMuñoz-García, Antonio JNombela-Franco, LuisSabate, ManelJimenez-Diaz, Victor AGarcía Del Blanco, BrunoLópez, JavierVarela-Falcón, Luis HSevilla, TeresaArnold, RomanRevilla, AnaSan Roman, J Alberto2023-01-252023-01-252018-02-13http://hdl.handle.net/10668/12130Transcatheter aortic valve implantation (TAVI) as a treatment in severe aortic stenosis (AS) is an excellent alternative to conventional surgical replacement. However, long-term outcomes are not benign. Renin-angiotensin system (RAS) blockade has shown benefit in terms of adverse remodelling in severe AS and after surgical replacement. The RAS blockade after TAVI (RASTAVI) trial aims to detect if there is a benefit in clinical outcomes and ventricular remodelling with this therapeutic strategy following the TAVI procedure. The study has been designed as a randomised 1:1 open-label study that will be undertaken in 8 centres including 336 TAVI recipients. All patients will receive the standard treatment. The active treatment group will receive ramipril as well. Randomisation will be done before discharge, after signing informed consent. All patients will be followed up for 3 years. A cardiac magnetic resonance will be performed initially and at 1 year to assess ventricular remodelling, defined as ventricular dimensions, ejection fraction, ventricular mass and fibrosis. Recorded events will include cardiac death, admission due to heart failure and stroke. The RASTAVI Study will improve the management of patients after TAVI and may help to increase their quality of life, reduce readmissions and improve long-term survival in this scenario. All authors and local ethics committees have approved the study design. All patients will provide informed consent. Results will be published irrespective of whether the findings are positive or negative. NCT03201185.enAttribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/adult cardiologyechocardiographyheart failurevalvular heart diseaseAngiotensin-Converting Enzyme InhibitorsAortic Valve StenosisHeart VentriclesHumansMagnetic Resonance ImagingProspective StudiesQuality of LifeRamiprilRenin-Angiotensin SystemResearch DesignRisk FactorsTranscatheter Aortic Valve ReplacementTreatment OutcomeVentricular Dysfunction, LeftVentricular Remodelingresearch article29440218open access10.1136/bmjopen-2017-0202552044-6055PMC5829899https://bmjopen.bmj.com/content/bmjopen/8/2/e020255.full.pdfhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC5829899/pdf