Animal studies show that the (ϩ)insert isoform is predominantly expressed in rapidly contracting phasic muscle and the (Ϫ)insert isoform is mostly found in slowly contracting tonic muscle. The expression of the (ϩ)insert isoform has never been demonstrated in human smooth muscle. We hypothesized that the (ϩ)insert isoform is present in humans and that its expression is commensurate with the organ's functional requirements. We report, for the first time, the sequence of the human (ϩ)insert isoform and quantification of its expression by real-time PCR and Western blot analysis in a panel of human organs. The (ϩ)insert isoform mRNA and protein expression levels are significantly greater in small intestine compared with all organs studied except for trachea and are significantly greater in trachea compared with uterus and aorta. To assess the functional significance of this differential myosin isoform expression between organs, we measured the rate of actin filament movement ( max) when propelled by myosin purified from rat organs, because the rat and human inserts are identical and their remaining sequences show 93% identity. max exhibits a rank correlation from the most tonic to the most phasic organ. The selective expression of the (ϩ)insert isoform observed among human organs suggests that it is an important determinant of tissue shortening velocity. A differential expression of the (ϩ)insert isoform could also account for altered contractile properties observed in human pathology. phasic and tonic smooth muscle; real-time polymerase chain reaction; in vitro motility assay SMOOTH MUSCLE IS FOUND in all hollow organs of the mammalian organism, and its function ranges from tone maintenance to content propulsion. Many studies point to the smooth muscle myosin heavy chain (SMMHC) as an important element contributing to these diverse contractile properties (see Ref. 16 for review). SMMHC is made up of a globular head, containing an ATPase site and an actin binding domain, and an ␣-helical tail to which regulatory and essential light chains are bound. SMMHC isoforms are generated by alternative splicing from a single gene (1,9,33,46). Four SMMHC isoforms have been described in various animal species. The first two isoforms identified differ in the carboxy terminus by distinct sequences of 43 (SM1) or 9 (SM2) amino acids (2, 33). The next two isoforms differ in the amino terminus by the presence [(ϩ)insert] or absence [(Ϫ)insert] of a seven-amino acid insert in a surface loop above the ATPase site (18, 46). The (ϩ) and (Ϫ)insert isoforms are also commonly referred to as SM-B and SM-A, respectively. All combinations of these isoforms are possible, i.e., (ϩ)insert SM1, (ϩ)insert SM2, (Ϫ)insert SM1, and (Ϫ)insert SM2. No difference in molecular mechanics has been observed between SM1 and SM2, but, as shown with myosin constructs, the sole presence of the amino-terminal insert doubles the actin-activated ATPase activity and the rate of actin filament movement ( max ) in the in vitro motility assay (17,22,36). Because of t...