14-23431584-C-T
Variant summary
Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PVS1_ModeratePM2PP5_Very_Strong
The NM_000257.4(MYH7):c.732+1G>A variant causes a splice donor, intron change. The variant allele was found at a frequency of 0.000000684 in 1,461,886 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (★★).
Frequency
Consequence
NM_000257.4 splice_donor, intron
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 12 ACMG points.
Transcripts
RefSeq
Ensembl
Frequencies
GnomAD3 genomes Cov.: 32
GnomAD3 exomes AF: 0.00000398 AC: 1AN: 251490Hom.: 0 AF XY: 0.00000736 AC XY: 1AN XY: 135920
GnomAD4 exome AF: 6.84e-7 AC: 1AN: 1461886Hom.: 0 Cov.: 33 AF XY: 0.00000138 AC XY: 1AN XY: 727242
GnomAD4 genome Cov.: 32
ClinVar
Submissions by phenotype
not provided Pathogenic:4
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Reported in probands with Ebstein anomaly, including a fetus with additional features of left ventricular hypertrophy, dilation, and noncompaction (PMID: 35209905, 27788187); Not observed at significant frequency in large population cohorts (gnomAD); Predicted to cause exon skipping that would disrupt the myosin motor domain; however, in the absence of definitive functional studies, the actual effect of this sequence change is unknown; Canonical splice site variant expected to result in aberrant splicing; other splice site variants in the MYH7 gene have been reported in association with cardiomyopathy (HGMD); This variant is associated with the following publications: (PMID: 25525159, 29300372, 18506004, 21551322, 12749056, 22859017, 35209905, 27788187, 30847666, 34758253, 35877568, 33500567, 36292635, 23861362) -
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Dilated cardiomyopathy 1S Pathogenic:1
The c.732+1G>A variant identified in the MYH7 gene substitutes a completely conserved Guanine for Adenine at the +1 canonical splice site in intron8/39 (+1 splice donor of exon 8). This variant is found with low frequency in gnomAD (1 heterozygote, 0 homozygotes; allele frequency: 3.98e-6), suggesting it is not a common benign variant in the populations represented in this database. This variant is reported as Pathogenic in ClinVar (VarID:14127), and has been identified in several individuals and families in the literature with left ventricular noncompaction and noncompaction cardiomyopathy [PMID: 18506004; PMID: 21551322; PMID: 22859017; PMID: 23861362]. Given its position at a canonical splice donor site, its low frequency in population databases, and presence in affected individuals and families in the literature in which it segregates with disease, the c.732+1G>A variant identified in the MYH7 gene is reported here as Pathogenic. -
Left ventricular noncompaction cardiomyopathy Pathogenic:1
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Left ventricular noncompaction Pathogenic:1
c.732+1G>A (MYH7; NM_000257.2; Chr14g.23900793C>T; GRCh37): The c.732+1G>A (also reported as c.818+1G>A) variant in MYH7 has been reported in 3 adults and 1 inf ant with LVNC, segregated with disease in 9 affected relatives from 3 families ( Klaassen 2008, Hoedemaeker 2013, Ng 2013). It has been identified in 1/17348 Eas t Asian chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.br oadinstitute.org/; dbSNP rs397516266). This variant occurs in the invariant regi on (+/- 1,2) of the splice consensus sequence and is predicted to cause altered splicing leading to an abnormal or absent protein. In summary, this variant meet s criteria to be classified as pathogenic for LVNC in an autosomal dominant mann er based upon predicted impact on the protein, presence in multiple affected ind ividuals, significant segregation evidence, and an extremely low frequency in th e general population. -
Left ventricular noncompaction 5 Pathogenic:1
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Hypertrophic cardiomyopathy Pathogenic:1
This sequence change affects a donor splice site in intron 8 of the MYH7 gene. It is expected to disrupt RNA splicing. Variants that disrupt the donor or acceptor splice site typically lead to a loss of protein function (PMID: 16199547), however the current clinical and genetic evidence is not sufficient to establish whether loss-of-function variants in MYH7 cause disease. The frequency data for this variant in the population databases is considered unreliable, as metrics indicate poor data quality at this position in the gnomAD database. Disruption of this splice site has been observed in individual(s) with Ebstein anomaly and left ventricular non-compaction (PMID: 18506004, 22859017, 27788187). It has also been observed to segregate with disease in related individuals. This variant is also known as c.818+1G>A. ClinVar contains an entry for this variant (Variation ID: 14127). Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. For these reasons, this variant has been classified as Pathogenic. -
Cardiovascular phenotype Pathogenic:1
The c.732+1G>A intronic variant results from a G to A substitution one nucleotide after coding exon 6 of the MYH7 gene. Alterations that disrupt the canonical splice site are expected to result in aberrant splicing. In silico splice site analysis predicts that this alteration will weaken the native splice donor site. The resulting transcript is predicted to be in-frame and is not expected to trigger nonsense-mediated mRNAdecay; however, direct evidence is unavailable. The exact functional effect of the altered amino acid sequence is unknown; however, this alteration has been reported in several individuals with left ventricular non-compaction (LVNC) and segregated with disease in two families (Klaassen S et al. Circulation, 2008 Jun;117:2893-901; Hoedemaekers YM et al. Ultrasound Obstet Gynecol, 2013 Mar;41:336-9; Kelly MA et al. Genet Med, 2018 Mar;20:351-359; van Lint FHM et al. Neth Heart J, 2019 Jun;27:304-309). Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
Hypertrophic cardiomyopathy 1 Pathogenic:1
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Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at