rs34819099

Variant summary

Our verdict is Benign. The variant received -20 ACMG points: 0P and 20B. BP4_StrongBP6_Very_StrongBS1BS2

The NM_001267550.2(TTN):​c.10100G>A​(p.Arg3367Gln) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0147 in 1,614,078 control chromosomes in the GnomAD database, including 197 homozygotes. In-silico tool predicts a benign outcome for this variant. 14/18 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Likely benign (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. R3367W) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.0096 ( 10 hom., cov: 33)
Exomes 𝑓: 0.015 ( 187 hom. )

Consequence

TTN
NM_001267550.2 missense

Scores

2
14

Clinical Significance

Benign/Likely benign criteria provided, multiple submitters, no conflicts B:26

Conservation

PhyloP100: 0.765

Publications

19 publications found
Variant links:
Genes affected
TTN (HGNC:12403): (titin) This gene encodes a large abundant protein of striated muscle. The product of this gene is divided into two regions, a N-terminal I-band and a C-terminal A-band. The I-band, which is the elastic part of the molecule, contains two regions of tandem immunoglobulin domains on either side of a PEVK region that is rich in proline, glutamate, valine and lysine. The A-band, which is thought to act as a protein-ruler, contains a mixture of immunoglobulin and fibronectin repeats, and possesses kinase activity. An N-terminal Z-disc region and a C-terminal M-line region bind to the Z-line and M-line of the sarcomere, respectively, so that a single titin molecule spans half the length of a sarcomere. Titin also contains binding sites for muscle associated proteins so it serves as an adhesion template for the assembly of contractile machinery in muscle cells. It has also been identified as a structural protein for chromosomes. Alternative splicing of this gene results in multiple transcript variants. Considerable variability exists in the I-band, the M-line and the Z-disc regions of titin. Variability in the I-band region contributes to the differences in elasticity of different titin isoforms and, therefore, to the differences in elasticity of different muscle types. Mutations in this gene are associated with familial hypertrophic cardiomyopathy 9, and autoantibodies to titin are produced in patients with the autoimmune disease scleroderma. [provided by RefSeq, Feb 2012]
TTN-AS1 (HGNC:44124): (TTN antisense RNA 1) This gene encodes a non-coding RNA transcribed from the opposite strand to the titin gene. [provided by RefSeq, Aug 2016]

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -20 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.0077604353).
BP6
Variant 2-178764191-C-T is Benign according to our data. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr2-178764191-C-T is described in CliVar as Benign/Likely_benign. Clinvar id is 46578.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BS1
Variant frequency is greater than expected in population nfe. GnomAd4 allele frequency = 0.00961 (1463/152276) while in subpopulation NFE AF = 0.0157 (1069/68028). AF 95% confidence interval is 0.0149. There are 10 homozygotes in GnomAd4. There are 680 alleles in the male GnomAd4 subpopulation. Median coverage is 33. This position passed quality control check.
BS2
High Homozygotes in GnomAd4 at 10 AD,AR gene

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
TTNNM_001267550.2 linkc.10100G>A p.Arg3367Gln missense_variant Exon 43 of 363 ENST00000589042.5 NP_001254479.2 A0A0A0MTS7
TTNNM_133379.5 linkc.10100G>A p.Arg3367Gln missense_variant Exon 43 of 46 ENST00000360870.10 NP_596870.2 Q8WZ42-6Q7Z3B7

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
TTNENST00000589042.5 linkc.10100G>A p.Arg3367Gln missense_variant Exon 43 of 363 5 NM_001267550.2 ENSP00000467141.1 A0A0A0MTS7
TTNENST00000360870.10 linkc.10100G>A p.Arg3367Gln missense_variant Exon 43 of 46 5 NM_133379.5 ENSP00000354117.4 Q8WZ42-6

Frequencies

GnomAD3 genomes
AF:
0.00962
AC:
1463
AN:
152158
Hom.:
10
Cov.:
33
show subpopulations
Gnomad AFR
AF:
0.00302
Gnomad AMI
AF:
0.0175
Gnomad AMR
AF:
0.00603
Gnomad ASJ
AF:
0.0193
Gnomad EAS
AF:
0.000578
Gnomad SAS
AF:
0.00766
Gnomad FIN
AF:
0.00302
Gnomad MID
AF:
0.00949
Gnomad NFE
AF:
0.0157
Gnomad OTH
AF:
0.00910
GnomAD2 exomes
AF:
0.0102
AC:
2554
AN:
251330
AF XY:
0.0110
show subpopulations
Gnomad AFR exome
AF:
0.00240
Gnomad AMR exome
AF:
0.00489
Gnomad ASJ exome
AF:
0.0225
Gnomad EAS exome
AF:
0.000980
Gnomad FIN exome
AF:
0.00212
Gnomad NFE exome
AF:
0.0156
Gnomad OTH exome
AF:
0.0116
GnomAD4 exome
AF:
0.0153
AC:
22341
AN:
1461802
Hom.:
187
Cov.:
32
AF XY:
0.0152
AC XY:
11036
AN XY:
727206
show subpopulations
African (AFR)
AF:
0.00260
AC:
87
AN:
33478
American (AMR)
AF:
0.00557
AC:
249
AN:
44724
Ashkenazi Jewish (ASJ)
AF:
0.0223
AC:
584
AN:
26134
East Asian (EAS)
AF:
0.00128
AC:
51
AN:
39694
South Asian (SAS)
AF:
0.00716
AC:
618
AN:
86256
European-Finnish (FIN)
AF:
0.00264
AC:
141
AN:
53416
Middle Eastern (MID)
AF:
0.00503
AC:
29
AN:
5768
European-Non Finnish (NFE)
AF:
0.0177
AC:
19684
AN:
1111938
Other (OTH)
AF:
0.0149
AC:
898
AN:
60394
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.460
Heterozygous variant carriers
0
1262
2524
3787
5049
6311
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Exome Hom
Variant carriers
0
762
1524
2286
3048
3810
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
GnomAD4 genome
AF:
0.00961
AC:
1463
AN:
152276
Hom.:
10
Cov.:
33
AF XY:
0.00913
AC XY:
680
AN XY:
74452
show subpopulations
African (AFR)
AF:
0.00301
AC:
125
AN:
41558
American (AMR)
AF:
0.00602
AC:
92
AN:
15288
Ashkenazi Jewish (ASJ)
AF:
0.0193
AC:
67
AN:
3472
East Asian (EAS)
AF:
0.000579
AC:
3
AN:
5182
South Asian (SAS)
AF:
0.00767
AC:
37
AN:
4824
European-Finnish (FIN)
AF:
0.00302
AC:
32
AN:
10608
Middle Eastern (MID)
AF:
0.0102
AC:
3
AN:
294
European-Non Finnish (NFE)
AF:
0.0157
AC:
1069
AN:
68028
Other (OTH)
AF:
0.00900
AC:
19
AN:
2110
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.501
Heterozygous variant carriers
0
77
153
230
306
383
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Genome Hom
Variant carriers
0
20
40
60
80
100
<30
30-35
35-40
40-45
45-50
50-55
55-60
60-65
65-70
70-75
75-80
>80
Age
Alfa
AF:
0.0143
Hom.:
69
Bravo
AF:
0.0104
TwinsUK
AF:
0.0165
AC:
61
ALSPAC
AF:
0.0202
AC:
78
ESP6500AA
AF:
0.00363
AC:
16
ESP6500EA
AF:
0.0164
AC:
141
ExAC
AF:
0.00996
AC:
1209
Asia WGS
AF:
0.00404
AC:
14
AN:
3478
EpiCase
AF:
0.0159
EpiControl
AF:
0.0164

ClinVar

Significance: Benign/Likely benign
Submissions summary: Benign:26
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

not specified Benign:10
Jun 24, 2013
Biesecker Lab/Clinical Genomics Section, National Institutes of Health
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:research

- -

-
Genome Diagnostics Laboratory, University Medical Center Utrecht
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Apr 09, 2025
Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
PreventionGenetics, part of Exact Sciences
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Sep 24, 2020
Athena Diagnostics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Mar 03, 2024
Women's Health and Genetics/Laboratory Corporation of America, LabCorp
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Jan 21, 2014
GeneDx
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant is considered likely benign or benign based on one or more of the following criteria: it is a conservative change, it occurs at a poorly conserved position in the protein, it is predicted to be benign by multiple in silico algorithms, and/or has population frequency not consistent with disease. -

Apr 12, 2012
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

Arg3367Gln in Exon 43 of TTN: This variant is not expected to have clinical sign ificance because it has been identified in 1.6% (114/7020) of European American chromosomes from a broad population by the NHLBI Exome Sequencing Project (http: //evs.gs.washington.edu/EVS; dbSNP rs34819099). -

-
Clinical Genetics, Academic Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

not provided Benign:4
-
Breakthrough Genomics, Breakthrough Genomics
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:not provided

- -

Nov 15, 2024
ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

-
Laboratory of Diagnostic Genome Analysis, Leiden University Medical Center (LUMC)
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

-
Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen
Significance:Likely benign
Review Status:no assertion criteria provided
Collection Method:clinical testing

- -

Autosomal recessive limb-girdle muscular dystrophy type 2J Benign:2
Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Early-onset myopathy with fatal cardiomyopathy Benign:2
Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Tibial muscular dystrophy Benign:2
Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Myopathy, myofibrillar, 9, with early respiratory failure Benign:2
Sep 10, 2021
Genome-Nilou Lab
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as benign is not then subjected to further curation. The score for this variant resulted in a classification of benign for this disease. -

Autosomal recessive limb-girdle muscular dystrophy type 2J;C1858763:Dilated cardiomyopathy 1G Benign:1
Feb 04, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Dilated cardiomyopathy 1G Benign:1
Jan 12, 2018
Illumina Laboratory Services, Illumina
Significance:Likely benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This variant was observed in the ICSL laboratory as part of a predisposition screen in an ostensibly healthy population. It had not been previously curated by ICSL or reported in the Human Gene Mutation Database (HGMD: prior to June 1st, 2018), and was therefore a candidate for classification through an automated scoring system. Utilizing variant allele frequency, disease prevalence and penetrance estimates, and inheritance mode, an automated score was calculated to assess if this variant is too frequent to cause the disease. Based on the score and internal cut-off values, a variant classified as likely benign is not then subjected to further curation. The score for this variant resulted in a classification of likely benign for this disease. -

Cardiomyopathy Benign:1
Nov 10, 2022
CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Cardiovascular phenotype Benign:1
Feb 07, 2013
Ambry Genetics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This alteration is classified as benign based on a combination of the following: population frequency, intact protein function, lack of segregation with disease, co-occurrence, RNA analysis, in silico models, amino acid conservation, lack of disease association in case-control studies, and/or the mechanism of disease or impacted region is inconsistent with a known cause of pathogenicity. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.088
BayesDel_addAF
Benign
-0.46
T
BayesDel_noAF
Benign
-0.42
CADD
Benign
18
DANN
Uncertain
0.98
Eigen
Benign
-0.37
Eigen_PC
Benign
-0.25
FATHMM_MKL
Uncertain
0.77
D
LIST_S2
Benign
0.84
T;T;T;.;T;T;T;T
MetaRNN
Benign
0.0078
T;T;T;T;T;T;T;T
MetaSVM
Benign
-0.99
T
PhyloP100
0.77
PrimateAI
Benign
0.30
T
PROVEAN
Benign
-1.3
N;N;.;.;N;N;.;N
REVEL
Benign
0.051
Sift
Benign
0.30
T;T;.;.;T;T;.;T
Sift4G
Benign
0.20
.;.;.;.;.;.;.;T
Polyphen
0.0050, 0.063
.;.;.;B;.;.;B;B
Vest4
0.21
MPC
0.097
ClinPred
0.0083
T
GERP RS
1.3
Mutation Taster
=92/8
polymorphism

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

Other links and lift over

dbSNP: rs34819099; hg19: chr2-179628918; API