rs199473220
Variant summary
Our verdict is Likely pathogenic. The variant received 7 ACMG points: 7P and 0B. PM1PP3_StrongPP5
The NM_001099404.2(SCN5A):c.3956G>T(p.Gly1319Val) variant causes a missense change involving the alteration of a conserved nucleotide. The variant allele was found at a frequency of 0.0000385 in 1,608,316 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a pathogenic outcome for this variant. 15/24 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Conflicting classifications of pathogenicity (no stars).
Frequency
Consequence
NM_001099404.2 missense
Scores
Clinical Significance
Conservation
Publications
- Brugada syndromeInheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: ClinGen, Orphanet
- Brugada syndrome 1Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Laboratory for Molecular Medicine, G2P, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
- dilated cardiomyopathyInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- dilated cardiomyopathy 1EInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: G2P, Labcorp Genetics (formerly Invitae), Ambry Genetics
- familial long QT syndromeInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
- long QT syndrome 3Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae), G2P
- sick sinus syndrome 1Inheritance: AD, AR Classification: STRONG, LIMITED Submitted by: Labcorp Genetics (formerly Invitae)
- progressive familial heart block, type 1AInheritance: SD, AD Classification: STRONG, MODERATE Submitted by: Ambry Genetics, Genomics England PanelApp
- atrial standstillInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- familial atrial fibrillationInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- familial isolated dilated cardiomyopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- familial sick sinus syndromeInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- paroxysmal familial ventricular fibrillationInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- progressive familial heart blockInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
- arrhythmogenic right ventricular cardiomyopathyInheritance: AD Classification: LIMITED Submitted by: ClinGen
- catecholaminergic polymorphic ventricular tachycardiaInheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
- short QT syndromeInheritance: AD Classification: NO_KNOWN Submitted by: ClinGen
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ACMG classification
Our verdict: Likely_pathogenic. The variant received 7 ACMG points.
Transcripts
RefSeq
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | MANE | Protein | UniProt |
|---|---|---|---|---|---|---|---|---|
| SCN5A | NM_001099404.2 | c.3956G>T | p.Gly1319Val | missense_variant | Exon 22 of 28 | ENST00000413689.6 | NP_001092874.1 | |
| SCN5A | NM_000335.5 | c.3953G>T | p.Gly1318Val | missense_variant | Exon 22 of 28 | ENST00000423572.7 | NP_000326.2 |
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt |
|---|---|---|---|---|---|---|---|---|---|---|
| SCN5A | ENST00000413689.6 | c.3956G>T | p.Gly1319Val | missense_variant | Exon 22 of 28 | 5 | NM_001099404.2 | ENSP00000410257.1 | ||
| SCN5A | ENST00000423572.7 | c.3953G>T | p.Gly1318Val | missense_variant | Exon 22 of 28 | 1 | NM_000335.5 | ENSP00000398266.2 |
Frequencies
GnomAD3 genomes AF: 0.0000394 AC: 6AN: 152206Hom.: 0 Cov.: 33 show subpopulations
GnomAD2 exomes AF: 0.0000420 AC: 10AN: 238270 AF XY: 0.0000465 show subpopulations
GnomAD4 exome AF: 0.0000385 AC: 56AN: 1456110Hom.: 0 Cov.: 31 AF XY: 0.0000415 AC XY: 30AN XY: 723674 show subpopulations
Age Distribution
GnomAD4 genome AF: 0.0000394 AC: 6AN: 152206Hom.: 0 Cov.: 33 AF XY: 0.0000403 AC XY: 3AN XY: 74350 show subpopulations
Age Distribution
ClinVar
Submissions by phenotype
not provided Pathogenic:8
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Reported in patients with Brugada syndrome, LQTS, and/or sudden cardiac arrest/death (PMID: 20646679, 17854786, 19251209, 20129283, 21273195, 24400668, 29759671, 33164571, 34930020); Identified in patients with DCM in published literature (PMID: 25179549, 28790152, 36264615); Published functional studies demonstrate this variant alters sodium channel gating properties and reduces the sodium current, which is consistent with a Brugada syndrome phenotype (PMID: 17854786); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; Also known as p.(G1318V); This variant is associated with the following publications: (PMID: 23414114, 19843921, 12106943, 24400668, 24573164, 19889341, 20129283, 21273195, 19251209, 24951569, 22373669, 30609406, 30662450, 29759671, 25904541, 30291343, 30847666, 31447099, 32377377, 33131149, 22581653, 33087929, 29709244, 33164571, 34135346, 35885997, 34461752, 30203441, 34697415, 25179549, 28790152, 20646679, 37061847, 36264615, 17854786, 34930020, 33797273) -
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This sequence change replaces glycine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 1319 of the SCN5A protein (p.Gly1319Val). This variant is present in population databases (rs199473220, gnomAD 0.009%). This missense change has been observed in individuals with autosomal dominant SCN5A-related conditions (PMID: 17854786, 24951569, 25179549, 25904541, 28790152; internal data). This variant is also known as G1318V. ClinVar contains an entry for this variant (Variation ID: 67838). 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 SCN5A function (PMID: 17854786). For these reasons, this variant has been classified as Pathogenic. -
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Brugada syndrome Pathogenic:2Other:1
This variant has been reported as associated with Brugada syndrome in the following publications (PMID:12106943;PMID:17854786;PMID:20129283). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -
proposed classification - variant undergoing re-assessment, contact laboratory -
This missense variant replaces glycine with valine at codon 1319 of the SCN5A protein. This variant is also known as p.Gly1318Val in the literature based on a different NM_000335 transcript. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). This variant is found within a highly conserved region of the transmembrane domain III. Rare nontruncating variants in this region have been shown to be significantly overrepresented in individuals with long QT syndrome (PMID: 32893267). Functional studies have shown that this variant causes a significant reduction in sodium current (PMID: 17854786, 19251209). This variant has been reported in over ten unrelated individuals affected with Brugada syndrome (PMID: 12106943, 17854786, 19251209, 21273195, 24951569, 29759671, 30847666, 32893267, 36516610, ClinVar SCV000291807.6), in an individual affected with long QT syndrome (PMID: 32893267), and in two individuals affected with progressive cardiac conduction disorders (PMID: 30059973). This variant has been shown to segregates with disease in four first-degree relatives from two families affected with cardiac conduction disease and cardiomypoathy (PMID: 25179549, 28790152). This variant has been identified in 11/269654 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Brugada syndrome (shorter-than-normal QT interval) Pathogenic:1
Variant summary: SCN5A c.3956G>T (p.Gly1319Val) results in a non-conservative amino acid change located in the Ion transport domain (IPR005821) of the encoded protein sequence. Algorithms developed to predict the effect of missense changes on protein structure and function all suggest that this variant is likely to be disruptive. The variant allele was found at a frequency of 4.2e-05 in 238270 control chromosomes. This frequency is not significantly higher than estimated for a pathogenic variant in SCN5A causing Brugada Syndrome (4.2e-05 vs 0.00017), allowing no conclusion about variant significance. c.3956G>T has been reported in the literature in individuals affected with or suspected of Brugada Syndrome (Amin_2011, Casini_2007, Kapplinger_2010, Adler_2016) as well as in other individuals with various cardiac phenotypes (Tadros_2017, Meregalli_2009). The variant was also reported in a proband and his son with dilated cardiomyopathy (Golbus_2014) as well as in a mother with reduced left ventricular ejection fraction and frequent ventricular ectopic beats and in her son with possible Arrhythmogenic Right Ventricular Cardiomyopathy (ARVC), who also carried another LMNA variant (Hoorntje_2017). These data indicate that the variant is likely to be associated with disease. In an in vitro functional study, the variant was shown to enhance slow inactivation of SCN5A channel (Casini_2007). However, another in vitro study, co-expressing the wild-type channel and the variant shows no reduction in channel current densities (Hoshi_2014). The following publications have been ascertained in the context of this evaluation (PMID: 26743238, 19843921, 21273195, 30059973, 17854786, 25179549, 28790152, 24573164, 20129283, 19251209, 29759671). ClinVar contains an entry for this variant (Variation ID: 67838). Based on the evidence outlined above, the variant was classified as likely pathogenic. -
SUDDEN INFANT DEATH SYNDROME;C1832680:Dilated cardiomyopathy 1E;C1837845:Sick sinus syndrome 1;C1859062:Long QT syndrome 3;C1879286:Progressive familial heart block, type 1A;C2751898:Ventricular fibrillation, paroxysmal familial, type 1;C3151464:Atrial fibrillation, familial, 10;C4551804:Brugada syndrome 1 Pathogenic:1
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Long QT syndrome 3 Pathogenic:1
The c.3956G>T (p.Gly1319Val) variant has been reported in several patients with Brugada syndrome [PMID 12106943, 19251209, 21273195]. Functional assays showed that this variant contributes to a reduction in sodium currents [PMID 17854786]. This variant was observed in only one individual at the heterozygous state in the ExAC population database (http://exac.broadinstitute.org/variant/3-38603913-C-A).This variant is conserved in mammals and while not clinically validated, computer-based algorithms (SIFT and Polyphen-2) predict this p.Gly1319Val change to be deleterious. This variant is thus classified as pathogenic. Pathogenic variants in SCN5A are also considered medically actionable [ACMG 59, PMID 27854360] -
Cardiovascular phenotype Pathogenic:1
The p.G1319V variant (also known as c.3956G>T), located in coding exon 21 of the SCN5A gene, results from a G to T substitution at nucleotide position 3956. The glycine at codon 1319 is replaced by valine, an amino acid with dissimilar properties. This variant has been previously reported in multiple affected individuals with confirmed or suspected Brugada syndrome or other arrhythmia phenotypes (Casini S et al. Cardiovasc Res. 2007;76(3):418-29; Meregalli PG et al. Heart Rhythm. 2009;6(3):341-8; Kapplinger JD et al. Heart Rhythm. 2010;7(1):33-46; van der Werf C et al. Heart Rhythm. 2010;7(10):1383-9; Amin AS et al. Europace. 2011;13(7):968-75), and was also reported in an adult male with dilated cardiomyopathy (DCM) and arrhythmia, and in his son who had signs of DCM (Golbus JR et al. Circ Cardiovasc Genet. 2014;7(6):751-9 (reported as p.G1318V)). One study reported that this alteration resulted in abnormal ion channel function (Casini S et al. Cardiovasc Res. 2007;76(3):418-29), while a second study found no impact on sodium current density when co-expressed with wild-type channels (Hoshi M et al. Circ Cardiovasc Genet. 2014;7(2):123-31). 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. -
Cardiac arrhythmia Pathogenic:1
This missense variant replaces glycine with valine at codon 1319 of the SCN5A protein. This variant is also known as p.Gly1318Val in the literature based on a different NM_000335 transcript. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). This variant is found within a highly conserved region of the transmembrane domain III. Rare nontruncating variants in this region have been shown to be significantly overrepresented in individuals with Brugada syndrome and long QT syndrome (PMID: 32893267). Functional studies have shown that this variant causes a significant reduction in sodium current (PMID: 17854786, 19251209). This variant has been reported in over ten unrelated individuals affected with Brugada syndrome (PMID: 12106943, 17854786, 19251209, 21273195, 24951569, 29759671, 30847666, 32893267, 36516610, 37061847, ClinVar SCV000291807.6), in an individual affected with long QT syndrome (PMID: 32893267), and in two individuals affected with progressive cardiac conduction disorders (PMID: 30059973). This variant has been shown to segregates with disease in four first-degree relatives from two families affected with cardiac conduction disease and cardiomypoathy (PMID: 25179549, 28790152). This variant has been identified in 11/269654 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Based on the available evidence, this variant is classified as Likely Pathogenic. -
Brugada syndrome 1 Uncertain:1
Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as VUS-3A. Following criteria are met: 0103 - Loss of function and gain of function are both known mechanisms of disease in this gene. Loss of function is usually associated with Brugada syndrome 1 (MIM#601144) and sick sinus syndrome 1 (SSS) (MIM#608567), whereas gain of function is usually associated with long QT syndrome 3 (LQTS) (MIM#603830). Dilated cardiomyopathy 1E (DCM) (MIM#601154) can be caused by variants with either a loss or gain of function mechanism (PMID: 29798782). (I) 0108 - This gene is associated with both recessive and dominant disease. Most conditions associated with this gene are dominantly inherited however, SSS may be caused by recessive variants (OMIM). (I) 0112 - The condition associated with this gene has incomplete penetrance (GeneReviews). (I) 0200 - Variant is predicted to result in a missense amino acid change from glycine to valine. (I) 0251 - This variant is heterozygous. (I) 0304 - Variant is present in gnomAD (v2 and v3) <0.01 (16 heterozygotes, 0 homozygotes). (SP) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools and highly conserved with a major amino acid change. (SP) 0600 - Variant is located in the ion transport domain (DECIPHER). (I) 0705 - No comparable missense variants have previous evidence for pathogenicity. (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. This variant has been classified as likely pathogenic and pathogenic by at least ten clinical diagnostic laboratories (ClinVar) and has been reported in multiple patients with Brugada syndrome (VCGS, PMIDs: 21273195, 17854786, 29759671), two patients with dilated cardiomyopathy (PMID: 25179549) and a patient with cardiomyopathy (PMID: 28790152). Finally, this variant has been proposed as a Dutch founder variant (PMID: 30847666). It should also be noted that this variant has been identified in unaffected individuals; however, it is unclear if they subsequently developed a cardiovascular disorder (PMIDs: 25904541, 34135346). (SP) 1002 - Moderate functional evidence supporting abnormal protein function. Patch clamp analysis has shown that this variant affects slow inactivation of the SCN5A channel. However, patch clamp assays have been shown to be unreliable, therefore results from these studies are used with caution during variant classification (PMID: 17854786). (I) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at