11-47352645-C-T

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1PS1_ModeratePM2

The NM_000256.3(MYBPC3):​c.3G>A​(p.Met1?) variant causes a start lost change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000188 in 1,595,446 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).

Frequency

Genomes: 𝑓 0.0000066 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000014 ( 0 hom. )

Consequence

MYBPC3
NM_000256.3 start_lost

Scores

6
6
4

Clinical Significance

Conflicting classifications of pathogenicity criteria provided, conflicting classifications P:1U:3

Conservation

PhyloP100: 1.83
Variant links:
Genes affected
MYBPC3 (HGNC:7551): (myosin binding protein C3) MYBPC3 encodes the cardiac isoform of myosin-binding protein C. Myosin-binding protein C is a myosin-associated protein found in the cross-bridge-bearing zone (C region) of A bands in striated muscle. MYBPC3 is expressed exclusively in heart muscle and is a key regulator of cardiac contraction. Mutations in this gene are a frequent cause of familial hypertrophic cardiomyopathy. [provided by RefSeq, May 2022]

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ACMG classification

Classification made for transcript

Verdict is Pathogenic. Variant got 12 ACMG points.

PVS1
Start lost variant, no new inframe start found.
PS1
Another start lost variant in NM_000256.3 (MYBPC3) was described as [Conflicting_classifications_of_pathogenicity] in ClinVar as 42747
PM2
Very rare variant in population databases, with high coverage;

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE UniProt
MYBPC3NM_000256.3 linkuse as main transcriptc.3G>A p.Met1? start_lost 1/35 ENST00000545968.6

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Appris UniProt
MYBPC3ENST00000545968.6 linkuse as main transcriptc.3G>A p.Met1? start_lost 1/355 NM_000256.3 P4Q14896-1
MYBPC3ENST00000399249.6 linkuse as main transcriptc.3G>A p.Met1? start_lost 1/345 A2
MYBPC3ENST00000544791.1 linkuse as main transcriptc.3G>A p.Met1? start_lost, NMD_transcript_variant 1/275

Frequencies

GnomAD3 genomes
AF:
0.00000657
AC:
1
AN:
152112
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.00
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.000193
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.00
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.00000433
AC:
1
AN:
231038
Hom.:
0
AF XY:
0.00000793
AC XY:
1
AN XY:
126104
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000653
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000139
AC:
2
AN:
1443334
Hom.:
0
Cov.:
30
AF XY:
0.00
AC XY:
0
AN XY:
717890
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.0000537
Gnomad4 SAS exome
AF:
0.00
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.00
Gnomad4 OTH exome
AF:
0.00
GnomAD4 genome
AF:
0.00000657
AC:
1
AN:
152112
Hom.:
0
Cov.:
32
AF XY:
0.0000135
AC XY:
1
AN XY:
74316
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.000193
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.00
Gnomad4 OTH
AF:
0.00
Bravo
AF:
0.0000302
ExAC
AF:
0.00000827
AC:
1

ClinVar

Significance: Conflicting classifications of pathogenicity
Submissions summary: Pathogenic:1Uncertain:3
Revision: criteria provided, conflicting classifications
LINK: link

Submissions by phenotype

Hypertrophic cardiomyopathy Uncertain:2
Uncertain significance, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthJun 15, 2023This variant results in the loss of the translation initiator methionine at codon 1 of the MYBPC3 protein. This variant is expected to disrupt the expression of the full-length MYBPC3 protein. The next in-frame methionine occurs at codon 103 in the Ig-like domain C0. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in compound heterozygous state with a truncation variant (p. Ile292PhefsTer8) in two siblings affected with hypertrophic cardiomyopathy, and in heterozygous state in their unaffected mother (PMID: 29524613). Different single nucleotide substitutions (c.3G>C, c.1A>T) causing the same initiator codon loss have been reported in two probands affected with hypertrophic cardiomyopathy (PMID: 25611685, 27532257). This variant has been identified in 2/262394 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -
Uncertain significance, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpAug 27, 2021This sequence change affects the initiator methionine of the MYBPC3 mRNA. The next in-frame methionine is located at codon 103. This variant is present in population databases (rs397516045, ExAC 0.01%). Disruption of the initiator codon has been observed in individual(s) with hypertrophic cardiomyopathy (PMID: 25611685, 27532257, 29524613). Experimental studies and prediction algorithms are not available or were not evaluated, and the functional significance of this variant is currently unknown. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -
not provided Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxMar 02, 2023Observed with a frameshift variant on the opposite allele (in trans) in twin siblings with hypertrophic cardiomyopathy in published literature; the c.3G>A variant was heterozygous in the asymptomatic father with normal echocardiogram (Zhou et al., 2018); Observed in a cohort of patients with sporadic dilated cardiomyopathy, although patient specific clinical information and familial segregation information were not provided (Xiao et al., 2021); Initiation codon variant in a gene for which loss-of-function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 28679633, 29524613, 33996946) -
Cardiomyopathy Uncertain:1
Uncertain significance, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthJun 06, 2023This variant results in the loss of the translation initiator methionine at codon 1 of the MYBPC3 protein. This variant is expected to disrupt the expression of the full-length MYBPC3 protein. The next in-frame methionine occurs at codon 103 in the Ig-like domain C0. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in compound heterozygous state with a truncation variant (p. Ile292PhefsTer8) in two siblings affected with hypertrophic cardiomyopathy, and in heterozygous state in their unaffected parent (PMID: 29524613). It has also been reported in an individual affected with dilated cardiomyopathy (PMID: 33996946). Different single nucleotide substitutions (c.3G>C, c.1A>T) causing the same initiator codon loss have been reported in individuals affected with hypertrophic cardiomyopathy (PMID: 25611685, 27532257, 30297972; communication with an external laboratory; ClinVar SCV003852942.1, SCV001504154.3). This variant has been identified in 2/262394 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
BayesDel_addAF
Uncertain
0.15
D
BayesDel_noAF
Pathogenic
0.16
CADD
Uncertain
24
DANN
Uncertain
1.0
DEOGEN2
Benign
0.23
T;T;T
Eigen
Uncertain
0.53
Eigen_PC
Uncertain
0.53
FATHMM_MKL
Pathogenic
0.98
D
LIST_S2
Uncertain
0.90
D;D;D
M_CAP
Pathogenic
0.55
D
MetaRNN
Pathogenic
0.98
D;D;D
MetaSVM
Benign
-0.35
T
MutationTaster
Benign
1.0
D;D;D
PROVEAN
Benign
-1.5
N;N;N
REVEL
Uncertain
0.36
Sift
Pathogenic
0.0
D;D;D
Sift4G
Pathogenic
0.0
D;D;D
Polyphen
0.85
P;.;.
Vest4
0.94
MutPred
0.89
Gain of catalytic residue at M1 (P = 0.0885);Gain of catalytic residue at M1 (P = 0.0885);Gain of catalytic residue at M1 (P = 0.0885);
MVP
0.83
ClinPred
0.98
D
GERP RS
4.5
Varity_R
0.95
gMVP
0.23

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.0
Details are displayed if max score is > 0.2

Find out detailed SpliceAI scores and Pangolin per-transcript scores at spliceailookup.broadinstitute.org

Publications

LitVar

Below is the list of publications found by LitVar. It may be empty.

Other links and lift over

dbSNP: rs397516045; hg19: chr11-47374196; COSMIC: COSV57032247; COSMIC: COSV57032247; API