14-23418234-C-T
Variant summary
Our verdict is Likely pathogenic. Variant got 8 ACMG points: 8P and 0B. PM1PM5PP2PP3_ModeratePP5
The NM_000257.4(MYH7):c.4145G>A(p.Arg1382Gln) variant causes a missense change. The variant allele was found at a frequency of 0.0000093 in 1,613,394 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). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R1382W) has been classified as Pathogenic.
Frequency
Consequence
NM_000257.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Likely_pathogenic. Variant got 8 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes AF: 0.0000131 AC: 2AN: 152244Hom.: 0 Cov.: 33
GnomAD3 exomes AF: 0.00000398 AC: 1AN: 251460Hom.: 0 AF XY: 0.00000736 AC XY: 1AN XY: 135910
GnomAD4 exome AF: 0.00000890 AC: 13AN: 1461150Hom.: 0 Cov.: 32 AF XY: 0.00000963 AC XY: 7AN XY: 726878
GnomAD4 genome AF: 0.0000131 AC: 2AN: 152244Hom.: 0 Cov.: 33 AF XY: 0.0000269 AC XY: 2AN XY: 74380
ClinVar
Submissions by phenotype
Hypertrophic cardiomyopathy Pathogenic:3Uncertain:1
The p.Arg1382Gln variant in MYH7 has been identified in at least 15 individuals with HCM (Nunez 2013, Zou 2013, Walsh 2017, Kassem 2017, Ambry pers. comm., Invi tae pers. comm., GeneDx pers. comm., LMM data). It has also been reported by oth er clinical laboratories in ClinVar (Variation ID 177788) and has been identifie d in 1/15304 of African chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org). Computational prediction tools and conservati on analysis do not provide strong support for or against an impact to the protei n. In summary, although additional studies are required to fully establish its c linical significance, the p.Arg1382Gln variant is likely pathogenic. ACMG/AMP Cr iteria applied: PS4, PM2. -
This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 1382 of the MYH7 protein (p.Arg1382Gln). This variant is present in population databases (rs727504325, gnomAD 0.007%). This missense change has been observed in individuals with clinical features of hypertrophic cardiomyopathy (PMID: 23283745, 23782526, 25132132, 27532257, 30972196, 31513939, 31941943, 33673806; internal data). ClinVar contains an entry for this variant (Variation ID: 177788). Invitae Evidence Modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) indicates that this missense variant is expected to disrupt MYH7 protein function with a positive predictive value of 95%. In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic. -
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The c.4145G>A (p.Arg1382Gln) variant in the MYH7 gene has been identified in numerous (>15) affected individuals with Hypertrophic Cardiomyopathy (PMID: 23283745, 23782526, 25132132, 31513939, 33673806, 31941943, 30972196, 28687478, 27532257, 33495597, 30847666, 25611685). In-silico computational prediction tools suggest that this variant may have deleterious effect on the protein function (REVEL score: 0.793). This variant is found to be rare (0.00000397; MAF<0.004%) in the general population database (gnomAD) and interpreted as likely pathogenic by several submitters in the ClinVar database (ClinVar ID: 177788). Another amino acid substitution at the same position, c.4144C>T (p.Arg1382Trp), has been reported in multiple individuals with hypertrophic cardiomyopathy (PMID: 12707239, 24047955, 23283745, 28138913, 27532257). Therefore, the c.4145G>A (p.Arg1382Gln) variant in the MYH7 gene is classified as likely pathogenic. -
not provided Pathogenic:2Uncertain:2
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Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 22958901, 27247418, 23782526, 23283745, 27532257, 24047955, 30972196, 31513939, 25132132, 28687478, 31941943, 31447099, 33673806, 28606303, Li_2024_Article, 37652022, 37937776) -
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Cardiomyopathy Pathogenic:2
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This missense variant replaces arginine with glutamine at codon 1382 in the LMM domain of the MYH7 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function. To our knowledge, functional studies have not been reported for this variant. This variant has been reported in over 20 individuals affected with hypertrophic cardiomyopathy (PMID: 23283745, 27532257, 28687478, 30972196, 31941943, 33495597, 33673806, Kassem 2017, Luo et al., 2019; communication with an external laboratory; ClinVar Variation ID: 177788). This variant has been identified in 1/251460 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Dilated cardiomyopathy 1S;C1842160:Myosin storage myopathy;C1850709:Myopathy, myosin storage, autosomal recessive;C3495498:Hypertrophic cardiomyopathy 1;C4552004:MYH7-related skeletal myopathy Pathogenic:1
PM2_Supporting+PS4+PP3_Moderate -
not specified Pathogenic:1
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Cardiovascular phenotype Pathogenic:1
The c.4145G>A (p.R1382Q) alteration is located in exon 30 (coding exon 28) of the MYH7 gene. This alteration results from a G to A substitution at nucleotide position 4145, causing the arginine (R) at amino acid position 1382 to be replaced by a glutamine (Q). Based on data from gnomAD, the A allele has an overall frequency of <0.001% (1/251460) total alleles studied. The highest observed frequency was 0.006% (1/16256) of African alleles. This variant has been detected in numerous individuals with hypertrophic cardiomyopathy (HCM) (Núñez, 2013; Zou, 2013; Kassem, 2017; Walsh, 2017; García-Molina, 2019; Ambry internal data; external communication). This amino acid position is highly conserved in available vertebrate species. This alteration is predicted to be deleterious by in silico analysis. Based on the available evidence, this alteration is classified as likely pathogenic. -
MYH7-related disorder Uncertain:1
The MYH7 c.4145G>A variant is predicted to result in the amino acid substitution p.Arg1382Gln. This variant has been reported in the heterozygous state in ten individuals with hypertrophic cardiomyopathy (HCM) (Nunez et al. 2013. PubMed ID: 23782526; Zou et al. 2013. PubMed ID: 23283745; Table S1B, Walsh et al. 2017. PubMed ID: 27532257; García-Molina et al. 2019. PubMed ID: 30972196; Table S2, Robyns et al. 2020. PubMed ID: 31513939; Additional File 2, Hathaway et al. 2021. PubMed ID: 33673806). This variant is reported in 0.0062% of alleles in individuals of African descent in gnomAD. In an updated version of the gnomAD this variant is reported in 0.036% of alleles in individuals of Middle Eastern descent (https://gnomad.broadinstitute.org/variant/14-23418234-C-T?dataset=gnomad_r4) which may be too common to be a cause of disease (Kelly et al. 2018. PubMed ID: 29300372). In ClinVar, this variant has conflicting interpretations of pathogenicity, ranging from uncertain to likely pathogenic (https://www.ncbi.nlm.nih.gov/clinvar/variation/177788/). At this time, the clinical significance of this variant is uncertain due to the absence of conclusive functional and genetic evidence. -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at