The APPROPRIATE study (ACE inhibitors for Potential PRevention Of the deleterious effects of Pulmonary Regurgitation In Adults with repaired TEtralogy of Fallot) was a randomized double-blinded, placebo-controlled trial comparing ramipril 10 mg daily with placebo in 64 patients with repaired tetralogy of Fallot and at least moderate pulmonary regurgitation [7]. Here, ACE is linked to Tetralogy of Fallot.