chr11-47337534-C-T

Variant summary

Our verdict is Pathogenic. Variant got 12 ACMG points: 12P and 0B. PM1PM5PP5_Very_Strong

The NM_000256.3(MYBPC3):​c.2459G>A​(p.Arg820Gln) variant causes a missense change. The variant allele was found at a frequency of 0.0000279 in 1,613,862 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Likely pathogenic (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R820W) has been classified as Likely pathogenic.

Frequency

Genomes: 𝑓 0.000026 ( 0 hom., cov: 31)
Exomes 𝑓: 0.000028 ( 0 hom. )

Consequence

MYBPC3
NM_000256.3 missense

Scores

4
13
3

Clinical Significance

Pathogenic/Likely pathogenic criteria provided, multiple submitters, no conflicts P:16

Conservation

PhyloP100: 3.87
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.

PM1
In a domain Fibronectin type-III 1 (size 96) in uniprot entity MYPC3_HUMAN there are 31 pathogenic changes around while only 3 benign (91%) in NM_000256.3
PM5
Other missense variant is known to change same aminoacid residue: Variant chr11-47337535-G-A is described in Lovd as [Likely_pathogenic].
PP5
Variant 11-47337534-C-T is Pathogenic according to our data. Variant chr11-47337534-C-T is described in ClinVar as [Likely_pathogenic]. Clinvar id is 8617.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr11-47337534-C-T is described in Lovd as [Pathogenic]. Variant chr11-47337534-C-T is described in Lovd as [Likely_pathogenic].

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect #exon/exons MANE Protein UniProt
MYBPC3NM_000256.3 linkuse as main transcriptc.2459G>A p.Arg820Gln missense_variant 25/35 ENST00000545968.6 NP_000247.2 Q14896-1A5YM48

Ensembl

Gene Transcript HGVSc HGVSp Effect #exon/exons TSL MANE Protein Appris UniProt
MYBPC3ENST00000545968.6 linkuse as main transcriptc.2459G>A p.Arg820Gln missense_variant 25/355 NM_000256.3 ENSP00000442795.1 Q14896-1
MYBPC3ENST00000399249.6 linkuse as main transcriptc.2459G>A p.Arg820Gln missense_variant 24/345 ENSP00000382193.2 A8MXZ9
MYBPC3ENST00000544791.1 linkuse as main transcriptn.2414-23G>A intron_variant 5 ENSP00000444259.1 F5GZR4

Frequencies

GnomAD3 genomes
AF:
0.0000263
AC:
4
AN:
152170
Hom.:
0
Cov.:
31
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:
0.000385
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.0000294
Gnomad OTH
AF:
0.00
GnomAD3 exomes
AF:
0.0000201
AC:
5
AN:
249220
Hom.:
0
AF XY:
0.0000222
AC XY:
3
AN XY:
135196
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.0000556
Gnomad SAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.0000354
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.0000280
AC:
41
AN:
1461692
Hom.:
0
Cov.:
33
AF XY:
0.0000344
AC XY:
25
AN XY:
727130
show subpopulations
Gnomad4 AFR exome
AF:
0.00
Gnomad4 AMR exome
AF:
0.00
Gnomad4 ASJ exome
AF:
0.00
Gnomad4 EAS exome
AF:
0.000202
Gnomad4 SAS exome
AF:
0.0000116
Gnomad4 FIN exome
AF:
0.00
Gnomad4 NFE exome
AF:
0.0000279
Gnomad4 OTH exome
AF:
0.0000166
GnomAD4 genome
AF:
0.0000263
AC:
4
AN:
152170
Hom.:
0
Cov.:
31
AF XY:
0.0000135
AC XY:
1
AN XY:
74336
show subpopulations
Gnomad4 AFR
AF:
0.00
Gnomad4 AMR
AF:
0.00
Gnomad4 ASJ
AF:
0.00
Gnomad4 EAS
AF:
0.000385
Gnomad4 SAS
AF:
0.00
Gnomad4 FIN
AF:
0.00
Gnomad4 NFE
AF:
0.0000294
Gnomad4 OTH
AF:
0.00
Alfa
AF:
0.0000405
Hom.:
0
Bravo
AF:
0.0000151
ExAC
AF:
0.0000165
AC:
2
EpiCase
AF:
0.000109
EpiControl
AF:
0.00

ClinVar

Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:16
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not provided Pathogenic:3
Likely pathogenic, criteria provided, single submitterclinical testingGeneDxDec 30, 2024Not 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: 18761664, 23197398, 16181148, 31524317, 23396983, 26688216, 24510615, 12951062, 15671604, 25281569, 27483260, 27532257, 28420666, 29398688, 20975235, 17263690, 22112859, 19149795, 16115294, 24793961, 18929575, 20800588, 28087566, 25351510, 24621997, 20474083, 28679633, 29907873, 30165862, 31451005, 30847666, 31447099, 31142139, 33487615, 36264615, 33673806, 33407484, 34135346, 33658040, 34542152, 34915024, 32492895, 34400558, 32830170, 22267749, 12628722, 18533079, 37652022) -
Pathogenic, criteria provided, single submitterclinical testingAiLife Diagnostics, AiLife DiagnosticsAug 03, 2021- -
Likely pathogenic, criteria provided, single submitterclinical testingRevvity Omics, RevvityOct 29, 2021- -
Hypertrophic cardiomyopathy 4 Pathogenic:3
Pathogenic, no assertion criteria providedliterature onlyOMIMFeb 01, 2005- -
Likely pathogenic, criteria provided, single submitterclinical testing3billionJan 03, 2022The variant has been observed in multiple (>3) similarly affected unrelated individuals(PMID: 12628722, 12951062, PS4_S). Functional studies provide moderate evidence of the variant having a damaging effect on the gene or gene product(PMID: 25281569, PS3_M). The variant was co-segregated with Cardiomyopathy, hypertrophic, 4 in multiple affected family members (PMID: 12628722, 12951062, PP1_P). It is observed at an extremely low frequency in the gnomAD v2.1.1 dataset (total allele frequency: 0.000020, PM2_M). A different missense change at the same codon has been reported as pathogenic/likely pathogenic with strong evidence (ClinVar ID: VCV000195850, PMID:20542340, PM5_M). Therefore, this variant is classified as pathogenic according to the recommendation of ACMG/AMP guideline. -
Pathogenic, criteria provided, single submitterclinical testingCenter for Genomic Medicine, King Faisal Specialist Hospital and Research CenterMar 26, 2024- -
Hypertrophic cardiomyopathy Pathogenic:3
Pathogenic, criteria provided, single submitterclinical testingLabcorp Genetics (formerly Invitae), LabcorpDec 04, 2023This sequence change replaces arginine, which is basic and polar, with glutamine, which is neutral and polar, at codon 820 of the MYBPC3 protein (p.Arg820Gln). This variant is present in population databases (rs2856655, gnomAD 0.006%). This missense change has been observed in individuals with hypertrophic cardiomyopathy (PMID: 12628722, 12951062, 18761664, 18929575, 20542340, 20800588, 22112859, 22267749, 25281569, 27483260, 28087566). It is commonly reported in individuals of Japan ancestry (PMID: 12628722, 12951062, 18761664, 18929575, 20542340, 20800588, 22112859, 22267749, 25281569, 27483260, 28087566). This variant is also known as c.2491G>A. ClinVar contains an entry for this variant (Variation ID: 8617). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. Experimental studies have shown that this missense change affects MYBPC3 function (PMID: 25281569). For these reasons, this variant has been classified as Pathogenic. -
Likely pathogenic, criteria provided, single submitterclinical testingLaboratory for Molecular Medicine, Mass General Brigham Personalized MedicineNov 03, 2022The p.Arg820Gln variant in MYBPC3 has been reported in 16 individuals with HCM, segregated with disease in 6 affected relatives from 3 families (Konno 2003 PMID: 12628722, Nanni 2003 PMID: 12951062, Alders 2003 PMID: 14563344, Shimizu 2003 PMID: 15671604, Konno 2006 PMID: 16181148, Kapplinger 2014 PMID: 24510615, and Hodatsu 2014 PMID: 25281569, LMM data), and has also been reported in ClinVar (Variation ID 8617). Additionally, it has been identified in 3/111676 of European chromosomes and 1/17248 of East Asian chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs2856655). Animal models (zebrafish) support that this variant causes HCM (Hodatsu et al. 2014 PMID: 25281569). In summary, this variant meets criteria to be classified as likely pathogenic for hypertrophic cardiomyopathy in an autosomal dominant manner. ACMG/AMP Criteria Applied: PS4, PM2_Supporting, PS3_Moderate, PP1_Moderate. -
Likely pathogenic, criteria provided, single submitterclinical testingAll of Us Research Program, National Institutes of HealthSep 16, 2024This missense variant replaces arginine with glutamine at codon 820 of the fibronectin type 3 domain C6 of the MYBPC3 protein. Computational prediction tools indicate that this variant has a neutral impact on protein structure and function. A functional study performed in a zebrafish model has shown that this variant causes a phenotype consistent with hypertrophic cardiomyopathy (PMID: 25281569). This variant has been reported in over 30 unrelated individuals affected with hypertrophic cardiomyopathy (PMID: 12628722, 14563344, 16181148, 22112859, 22267749, 24510615, 25351510, 27483260, 27532257, 28087566, 32492895, 32830170, 32841044, 33407484, 33487615, 33495596, 33495597, 33658040, 33673806, 33782553, 34542152, 38489124, 38757491). It has been shown that this variant segregates with disease in six affected individuals across three families (PMID: 12628722). This variant has been reported in an individual affected with pediatric hypertrophic cardiomyopathy in compound heterozygous state with a different MYBPC3 variant (PMID: 25281569). This variant has also been reported in two individuals affected with dilated cardiomyopathy (PMID: 12628722, 15671604, 31524317). A different variant affecting the same codon, p.Arg820Trp, is considered to be disease-causing (ClinVar variation ID: 195850), suggesting that arginine at this position is important for MYBPC3 protein function. This variant has been identified in 5/249220 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Cardiomyopathy Pathogenic:2
Likely pathogenic, criteria provided, single submitterclinical testingCHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern OntarioFeb 05, 2018- -
Likely pathogenic, criteria provided, single submitterclinical testingColor Diagnostics, LLC DBA Color HealthJun 20, 2023This missense variant replaces arginine with glutamine at codon 820 of the fibronectin type 3 domain C6 of the MYBPC3 protein. Computational prediction suggests that this variant may not impact protein structure and function (internally defined REVEL score threshold <= 0.5, PMID: 27666373). Functional studies in zebrafish have shown a phenotype consistent with hypertrophic cardiomyopathy (PMID: 25281569). This variant has been reported in over 20 unrelated individuals affected with hypertrophic cardiomyopathy (PMID: 12628722, 12951062, 14563344, 16181148, 22112859, 22267749, 24510615, 25351510, 27483260, 27532257, 28087566, 32492895, 32830170, 32841044, 33407484, 33487615, 33495596, 33495597, 33658040, 33673806, 33782553). It has been shown that this variant segregates with disease in 6 affected individuals across 3 families (PMID: 12628722). This variant has been reported in an individual affected with pediatric hypertrophic cardiomyopathy in compound heterozygous state with a different MYBPC3 variant (PMID: 25281569). This variant has also been reported in 2 individuals affected with dilated cardiomyopathy (PMID: 12628722, 15671604, 31524317). A different variant affecting the same codon, p.Arg820Trp, is considered to be disease-causing (ClinVar variation ID: 195850), suggesting that arginine at this position is important for MYBPC3 protein function. This variant has been identified in 5/249220 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Primary familial hypertrophic cardiomyopathy Pathogenic:2
Pathogenic, criteria provided, single submitterclinical testingClinical Center for Gene Diagnosis and Therapy, Department of Cardiovascular Surgery, The Second Xiangya Hospital of Central South UniversityJun 01, 2023- -
Pathogenic, criteria provided, single submitterclinical testingWomen's Health and Genetics/Laboratory Corporation of America, LabCorpJul 10, 2023Variant summary: MYBPC3 c.2459G>A (p.Arg820Gln) results in a conservative amino acid change located in the fibronectin type III domain (IPR003961) of the encoded protein sequence. Two of four in-silico tools predict a benign effect of the variant on protein function. The variant allele was found at a frequency of 2e-05 in 249220 control chromosomes (gnomAD). c.2459G>A has been reported in the literature in multiple individuals and several families affected with Hypertrophic Cardiomyopathy, many of East Asian ancestry (e.g. Konno_2003, Hodatsu_2014, Chung_2020). These data indicate that the variant is very likely to be associated with disease. A publication reporting experimental evidence evaluating an impact on protein function in a zebrafish model suggests the variant may result in a more severe cardiac phenotype when together with p.Val762Asp in comparison to p.Val762Asp alone; however, since p.Arg820Gln was not examined alone, this study does not necessarily allow convincing conclusions about the variant effect (Hodatsu_2014). The following publications have been ascertained in the context of this evaluation (PMID: 32380161, 25281569, 12628722). Nine submitters have cited clinical-significance assessments for this variant to ClinVar after 2014 and all classified the variant as pathogenic/likely pathogenic. Based on the evidence outlined above, the variant was classified as pathogenic. -
Hypertrophic cardiomyopathy 4;C3715165:Left ventricular noncompaction 10 Pathogenic:1
Pathogenic, criteria provided, single submitterclinical testingFulgent Genetics, Fulgent GeneticsOct 16, 2021- -
Cardiovascular phenotype Pathogenic:1
Likely pathogenic, criteria provided, single submitterclinical testingAmbry GeneticsJul 15, 2024The p.R820Q variant (also known as c.2459G>A), located in coding exon 25 of the MYBPC3 gene, results from a G to A substitution at nucleotide position 2459. The arginine at codon 820 is replaced by glutamine, an amino acid with highly similar properties. This alteration has been reported in multiple individuals with hypertrophic cardiomyopathy (HCM), and has been shown to segregate with disease (Konno T et al. J. Am. Coll. Cardiol., 2003 Mar;41:781-6; Nanni L et al. Biochem. Biophys. Res. Commun., 2003 Sep;309:391-8; Bahrudin U et al. J. Mol. Biol., 2008 Dec;384:896-907; Otsuka H et al. Circ. J., 2012 Nov;76:453-61; Lopes LR et al. Heart, 2015 Feb;101:294-301; Seidelmann SB et al. Circ Cardiovasc Genet, 2017 Feb;10; Walsh R et al. Genet. Med., 2017 Feb;19:192-203). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Based on the majority of available evidence to date, this variant is likely to be pathogenic. -
MYBPC3-related disorder Pathogenic:1
Likely pathogenic, no assertion criteria providedclinical testingPreventionGenetics, part of Exact SciencesMar 14, 2024The MYBPC3 c.2459G>A variant is predicted to result in the amino acid substitution p.Arg820Gln. This variant has been reported in the heterozygous state in individuals with hypertrophic cardiomyopathy and segregated with disease in multiple families (see, for example, Konno et al. 2003. PubMed ID: 12628722; Kim et al. 2020. PubMed ID: 32492895; Supplemental Table 2, Field et al. 2022. PubMed ID: 34400558), although it has been detected in the heterozygous state in asymptomatic carriers as well (Konno et al. 2003. PubMed ID: 12628722; Hayashi et al. 2018. PubMed ID: 29907873). It has also been described in the compound heterozygous state with a second MYBPC3 variant in one individual, who was noted to have substantial left ventricular hypertrophy at age 11 (Hodatsu et al. 2014. PubMed ID: 25281569). In vitro and in vivo experimental studies suggest this variant may affect protein function through impaired protein stability or protein-protein interactions within the sarcomere (Hodatsu et al. 2014. PubMed ID: 25281569; Nadvi et al. 2015. PubMed ID: 26688216; Pearce et al. 2024. PubMed ID: 38042491). Alternative nucleotide changes affecting the same amino acid (p.Arg820Trp, p.Arg820Pro) have been reported in individuals with hypertrophic cardiomyopathy (Ripoll Vera et al 2010. PubMed ID: 20542340; Supplementary Table S2, Sepp et al. 2022. PubMed ID: 35626289 ). This variant is reported in 0.0056% of alleles in individuals of East Asian descent in gnomAD. This variant is interpreted as likely pathogenic. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.37
CardioboostCm
Pathogenic
0.96
BayesDel_addAF
Uncertain
0.14
D
BayesDel_noAF
Pathogenic
0.14
CADD
Pathogenic
28
DANN
Pathogenic
1.0
DEOGEN2
Benign
0.37
T;T;T
Eigen
Uncertain
0.64
Eigen_PC
Uncertain
0.61
FATHMM_MKL
Uncertain
0.89
D
LIST_S2
Pathogenic
0.99
D;D;D
M_CAP
Uncertain
0.22
D
MetaRNN
Uncertain
0.66
D;D;D
MetaSVM
Benign
-0.38
T
MutationAssessor
Uncertain
2.2
M;.;.
PrimateAI
Uncertain
0.67
T
PROVEAN
Uncertain
-2.9
D;.;D
REVEL
Uncertain
0.39
Sift
Uncertain
0.0050
D;.;D
Sift4G
Uncertain
0.0090
D;D;D
Vest4
0.78
MVP
0.81
MPC
0.89
ClinPred
0.98
D
GERP RS
4.6
Varity_R
0.51
gMVP
0.64

Splicing

Name
Calibrated prediction
Score
Prediction
SpliceAI score (max)
0.10
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: rs2856655; hg19: chr11-47359085; COSMIC: COSV99920803; API