Mechanisms of angiotensin II formation in humans.

Various organs, including the heart and blood vessels, apparently contain tissue renin-angiotensin systems. Through autocrine and paracrine activity, locally produced angiotensin II (Ang II) may well play an important role in cardiovascular homeostasis; in pathological conditions. Ang II may also contribute to the remodelling of the heart and vasculature. In addition to angiotensin converting enzyme (ACE), a cardiac Ang II forming serine proteinase (human heart chymase) has been identified in the left ventricle of the human heart. The different cellular and regional distributions of ACE and chymase in the heart as well as in the blood vessels suggest distinct pathophysiological roles for these two Ang II forming enzymes. Several reports indicate that both ACE-dependent and ACE-independent Ang II formation appear to occur in hypoxic or ischaemic hearts or blood vessels in vivo and seem to be involved in the pathological changes seen in these organs. However, chymase-dependent Ang II formation--which is chymostatin sensitive but aprotinin insensitive--does not explain all ACE-independent Ang II formation. Therefore, it is important to elucidate the mechanisms of tissue Ang II formation in humans and their contribution to the pathophysiological changes in cardiovascular disease.