Moreover, the role of the RAAS in PAH is complicated by the fact that angiotensin-(1-7), the product of angiotensin II metabolism by angiotensin-converting-enzyme (ACE)-2 (50), mitigates pulmonary vascular disease, leading to decreased RV fibrosis, RV hypertrophy (RVH), and RV systolic pressure in monocrotaline rats (51). Here, ACE2 is linked to pulmonary arterial hypertension.