rs376395543
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Variant summary
Our verdict is Pathogenic. Variant got 11 ACMG points: 11P and 0B. PVS1_ModeratePP3PP5_Very_Strong
The NM_000256.3(MYBPC3):βc.26-2A>G variant causes a splice acceptor, intron change. The variant allele was found at a frequency of 0.0000392 in 1,581,032 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 3/3 splice prediction tools predicting alterations to normal splicing. Variant has been reported in ClinVar as Likely pathogenic (β β ).
Frequency
Genomes: π 0.000020 ( 0 hom., cov: 32)
Exomes π: 0.000041 ( 0 hom. )
Consequence
MYBPC3
NM_000256.3 splice_acceptor, intron
NM_000256.3 splice_acceptor, intron
Scores
1
4
2
Splicing: ADA: 1.000
2
Clinical Significance
Conservation
PhyloP100: 5.77
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 11 ACMG points.
PVS1
Splicing +-2 bp (donor or acceptor) variant, product NOT destroyed by NMD, known LOF gene, truncates exone, which is 0.06954248 fraction of the gene. Cryptic splice site detected, with MaxEntScore 6.9, offset of 6, new splice context is: acctggcccttcggtctcAGctt. Cryptic site results in inframe change. If cryptic site found is not functional and variant results in exon loss, it results in inframe change.
PP3
Multiple lines of computational evidence support a deleterious effect 5: Cadd, dbscSNV1_ADA, dbscSNV1_RF, max_spliceai, Eigen [when BayesDel_addAF, MutationTaster was below the threshold]
PP5
Variant 11-47351507-T-C is Pathogenic according to our data. Variant chr11-47351507-T-C is described in ClinVar as [Likely_pathogenic]. Clinvar id is 42644.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr11-47351507-T-C is described in Lovd as [Likely_pathogenic]. Variant chr11-47351507-T-C is described in Lovd as [Pathogenic].
Transcripts
RefSeq
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Protein | Appris | UniProt |
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MYBPC3 | ENST00000545968.6 | c.26-2A>G | splice_acceptor_variant, intron_variant | 5 | NM_000256.3 | ENSP00000442795.1 | ||||
MYBPC3 | ENST00000399249.6 | c.26-2A>G | splice_acceptor_variant, intron_variant | 5 | ENSP00000382193.2 | |||||
MYBPC3 | ENST00000544791.1 | n.26-2A>G | splice_acceptor_variant, intron_variant | 5 | ENSP00000444259.1 |
Frequencies
GnomAD3 genomes AF: 0.0000197 AC: 3AN: 152218Hom.: 0 Cov.: 32
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GnomAD3 exomes AF: 0.0000268 AC: 6AN: 223986Hom.: 0 AF XY: 0.0000409 AC XY: 5AN XY: 122320
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GnomAD4 exome AF: 0.0000413 AC: 59AN: 1428814Hom.: 0 Cov.: 36 AF XY: 0.0000454 AC XY: 32AN XY: 705224
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GnomAD4 genome AF: 0.0000197 AC: 3AN: 152218Hom.: 0 Cov.: 32 AF XY: 0.0000403 AC XY: 3AN XY: 74374
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ClinVar
Significance: Pathogenic/Likely pathogenic
Submissions summary: Pathogenic:32
Revision: criteria provided, multiple submitters, no conflicts
LINK: link
Submissions by phenotype
not provided Pathogenic:11
Pathogenic, no assertion criteria provided | clinical testing | Clinical Genetics, Academic Medical Center | - | - - |
Pathogenic, no assertion criteria provided | clinical testing | Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+ | - | - - |
Pathogenic, no assertion criteria provided | clinical testing | Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen | - | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Blueprint Genetics | Apr 06, 2018 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Institute for Clinical Genetics, University Hospital TU Dresden, University Hospital TU Dresden | Nov 04, 2022 | PP1_STR, PS4, PVS1_MOD, PM2_SUP - |
Pathogenic, no assertion criteria provided | clinical testing | Clinical Genetics DNA and cytogenetics Diagnostics Lab, Erasmus MC, Erasmus Medical Center | - | - - |
Pathogenic, criteria provided, single submitter | clinical testing | CeGaT Center for Human Genetics Tuebingen | Mar 01, 2023 | MYBPC3: PVS1, PM2 - |
Pathogenic, no assertion criteria provided | clinical testing | Genome Diagnostics Laboratory, University Medical Center Utrecht | - | - - |
Pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Dec 16, 2024 | Canonical splice site variant predicted to result in an in-frame loss of the adjacent exon in a gene for which loss of function is a known mechanism of disease; Not observed at significant frequency in large population cohorts (gnomAD); This variant is associated with the following publications: (PMID: 25525159, 27532257, 25637381, 18957093, 24510615, 29029073, 15519027, 22267749, 21750094, 27831900, 23674513, 34542152, 35537032, 33258288, 34570182, 32686758, 34691145, 31447099, 33673806, 33087929, 34135346, 37652022, 34493867, 36264615, 37767697, 39160446) - |
Pathogenic, criteria provided, single submitter | clinical testing | AiLife Diagnostics, AiLife Diagnostics | Jan 27, 2022 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | ARUP Laboratories, Molecular Genetics and Genomics, ARUP Laboratories | Feb 28, 2024 | The MYBPC3 c.26-2A>G variant (rs376395543) is reported in the literature in multiple individuals affected with hypertrophic cardiomyopathy or left ventricular noncompaction and segregates with disease in several kindreds (Ehlermann 2008, Hathaway 2021, McGurk 2023, Sedaghat-Hamedani 2017, Van Driest 2004, Walsh 2017). This variant has been reported to be incompletely penetrant (McGurk 2023, Sedaghat-Hamedani 2017), and it is found in the general population with an overall allele frequency of 0.003% (7/255,378 alleles) in the Genome Aggregation Database (v2.1.1). This variant disrupts the canonical splice acceptor site of intron 1, which is likely to negatively impact gene function. Based on available information, this variant is considered to be pathogenic. References: Ehlermann P et al. Adverse events in families with hypertrophic or dilated cardiomyopathy and mutations in the MYBPC3 gene. BMC Med Genet. 2008 Oct 28;9:95. PMID: 18957093. Hathaway J et al. Diagnostic yield of genetic testing in a heterogeneous cohort of 1376 HCM patients. BMC Cardiovasc Disord. 2021 Mar 5;21(1):126. PMID: 33673806. McGurk KA et al. The penetrance of rare variants in cardiomyopathy-associated genes: A cross-sectional approach to estimating penetrance for secondary findings. Am J Hum Genet. 2023 Sep 7;110(9):1482-1495. PMID: 37652022. Sedaghat-Hamedani F et al. Clinical genetics and outcome of left ventricular non-compaction cardiomyopathy. Eur Heart J. 2017 Dec 7;38(46):3449-3460. PMID: 29029073. Van Driest SL et al. Myosin binding protein C mutations and compound heterozygosity in hypertrophic cardiomyopathy. J Am Coll Cardiol. 2004 Nov 2;44(9):1903-10. PMID: 15519027. Walsh R et al. Reassessment of Mendelian gene pathogenicity using 7,855 cardiomyopathy cases and 60,706 reference samples. Genet Med. 2017 Feb;19(2):192-203. PMID: 27532257. - |
Hypertrophic cardiomyopathy 4 Pathogenic:5
Pathogenic, criteria provided, single submitter | clinical testing | Centre for Mendelian Genomics, University Medical Centre Ljubljana | Jan 01, 2016 | This variant was classified as: Pathogenic. The following ACMG criteria were applied in classifying this variant: PVS1,PS1,PP3. - |
Pathogenic, criteria provided, single submitter | clinical testing | Institute of Human Genetics Munich, Klinikum Rechts Der Isar, TU MΓΌnchen | Nov 07, 2022 | - - |
Pathogenic, criteria provided, single submitter | clinical testing | Clinical Genomics Laboratory, Stanford Medicine | Jun 29, 2021 | The c.26-2A>G variant in the MYBPC3gene has been previously reported in many unrelated individuals with hypertrophic cardiomyopathy(Van Driest et al., 2004; Ehlermann et al., 2008; Kapplinger et al., 2014; Walsh et al., 2017), and segregated in 6 affected relatives from a five-generation family with left ventricular non-compaction (Sedaghat-Hamedani et al., 2017). This variant has been identified in6/115,748 European non-Finnish chromosomes(7/255,378 chromosomesoverall)by the Genome Aggregation Database (http://gnomad.broadinstitute.org/). Although this variant has been seen in the general population, its frequency is low enough to be consistent with the prevalence of hypertrophic cardiomyopathy.The c.26-2A>G variant alters the canonical acceptor splice site in intron 1, which is predicted to result in abnormal gene splicing.Heterozygous loss-of-function is an established mechanism of disease for the MYBPC3gene(Helms et al., 2020).These data were assessed using the ACMG/AMP variant interpretation guidelines. In summary, there is sufficient evidence to classify the c.26-2A>G variant as pathogenic for autosomal dominant hypertrophic cardiomyopathy based on the information above. [ACMG evidence codes used: PVS1_Strong; PS4; PM2; PP1] - |
Pathogenic, criteria provided, single submitter | clinical testing | Institute of Human Genetics, University of Leipzig Medical Center | May 29, 2019 | - - |
Pathogenic, criteria provided, single submitter | research | HudsonAlpha Institute for Biotechnology, HudsonAlpha Institute for Biotechnology | May 08, 2018 | - - |
Hypertrophic cardiomyopathy Pathogenic:4
Pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Aug 29, 2019 | The c.26-2A>G variant in MYBPC3 has been reported in >10 individuals with HCM, segregated with disease in 4 affected relatives from 3 families, including 1 obligate carrier (Van Driest 2004, Ehlermann 2008, Waldmuller 2011, Page 2012, Kapplinger 2014, LMM unpublished data). It has also been reported in ClinVar (Variation ID 42644), in 7/114350 of European chromosomes by the Genome Aggregation Database (gnomAD, http://gnomad.broadinstitute.org; dbSNP rs376395543), and in 2 unaffected adults (Natarajan 2016, LMM unpublished data). For diseases with clinical variability and reduced penetrance, pathogenic variants may be present at a low frequency in the general population. Finally, this variant occurs in the invariant region (+/- 1,2) of the splice consensus sequence, and the variant is predicted to damage the canonical splice site. Heterozygous splice variants in MYBPC3 are prevalent in cases of HCM. However, an alternate splice site is predicted to occur 6 bps downstream, and, if used, would lead to an in-frame deletion of 2 amino acids, though these computational tools are not predictive enough to suggest this alternative splice site would be use in vivo. In summary, this variant meets criteria to be classified as pathogenic for HCM in an autosomal dominant manner based upon predicted impact to the protein, presence in affected individuals and segregation studies. The ACMG/AMP Criteria applied: PS4; PM4; PP1_Supporting; PM2_Supporting. - |
Pathogenic, criteria provided, single submitter | clinical testing | Labcorp Genetics (formerly Invitae), Labcorp | Jan 30, 2025 | This sequence change affects an acceptor splice site in intron 1 of the MYBPC3 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), and loss-of-function variants in MYBPC3 are known to be pathogenic (PMID: 19574547). This variant is present in population databases (rs376395543, gnomAD 0.006%). Disruption of this splice site has been observed in individuals with hypertrophic cardiomyopathy (PMID: 15519027, 18957093, 22267749, 23674513, 24510615, 27532257). ClinVar contains an entry for this variant (Variation ID: 42644). 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. - |
Pathogenic, criteria provided, single submitter | clinical testing | All of Us Research Program, National Institutes of Health | Sep 18, 2024 | This variant causes an A to G nucleotide substitution at the -2 position of intron 1 splice acceptor site of the MYBPC3 gene. Splice site prediction tools predict that this variant may have a significant impact on RNA splicing. Although RNA studies have not been reported, this variant is expected to disrupt RNA splicing and result in an absent or non-functional protein product. This variant has been reported in over 20 individuals affected with hypertrophic cardiomyopathy (PMID: 15519027, 18957093, 21750094, 22267749, 23674513, 24510615, 27532257, 27831900) and has been shown to segregate with disease in 4 individuals from 2 families (communication with en external laboratory; ClinVar SCV000059162.6). This variant has been identified in 7/255378 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of MYBPC3 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. - |
Pathogenic, criteria provided, single submitter | clinical testing | Human Genome Sequencing Center Clinical Lab, Baylor College of Medicine | Jul 18, 2018 | The c.26-2A>G variant of the MYBPC3 gene disrupts the splicing acceptor site in intron 1 and is expected to alter RNA splicing, leading to disrupted protein structure and function. Loss-of-function variants in MYBPC3 are known to be pathogenic (PMID: 19574547). This variant has been reported in over 20 individuals affected with hypertrophic cardiomyopathy (PMID: 15519027, 18957093, 21750094, 22267749, 23674513, 24510615, 27532257, 27831900). This variant has been identified in 3/255378 chromosomes in the general population by the gnomAD database. Based on these evidence, the c.26-2A>G variant of the MYBPC3 gene is classified as pathogenic. - |
Hypertrophic cardiomyopathy 4;C3715165:Left ventricular noncompaction 10 Pathogenic:3
Pathogenic, criteria provided, single submitter | clinical testing | Center for Genomics, Ann and Robert H. Lurie Children's Hospital of Chicago | Mar 30, 2021 | MYBPC3 NM_000256.3 exon 2 c.26-2A>G: This variant has been reported in the literature in several individuals with HCM or LVNC, segregating with disease in multiple affected family members within at least two families (Van Driest 2004 PMID:15519027, Ehlermann 2008 PMID:18957093, Page 2012 PMID:22267749, Sedaghat-Hamedani 2017 PMID:29029073, Walsh 2017 PMID:27532257). This variant is present in 0.005% (6/115748) of European alleles in the Genome Aggregation Database http://gnomad.broadinstitute.org/variant/11-47373058-T-C). Please note, disease causing variants may be present in control databases at low frequencies, reflective of the general population, reduced penetrance, and/or variable expressivity. This variant is present in ClinVar, with several labs classifying this variant as pathogenic or likely pathogenic (Variation ID:42644). Evolutionary conservation and computational predictive tools for this variant are limited or unavailable. Of note, this variant alters the consensus splice sequence (+/- 1,2) which is predicted to result in an absent or abnormal protein. Loss of function variants are a known mechanism of disease for this gene (Marston 2009 PMID:19574547). In summary, this variant is classified as pathogenic based on the data above (segregation studies, impact to protein etc.) - |
Pathogenic, criteria provided, single submitter | clinical testing | New York Genome Center | Sep 16, 2022 | The c.26-2A>G variant identified in the MYBPC3 gene has been reported in ClinVar as Pathogenic by multiple submitters (VarID:42644) and has been reported in several individuals affected with hypertrophic cardiomyopathy in the literature [PMID: 15519027, 18957093, 27532257, 33673806,others.] The c.26-2A>G variant is observed in 10 alleles (~0.002% minor allele frequency with 0 homozygotes) in population databases (gnomAD v2.1.1 and v3.1.2,TOPMed Freeze 8), suggesting it is not a common benign variant in the populations represented in those databases. The c.26-2A>G variant in MYBPC3 is located inthe canonical splice acceptor site preceding exon 2 of this 34-exon gene, and is presumed to affect mRNA splicing which might result in exon skipping or full/partial intron retention. Based on available evidence this c.26-2A>G variant identified in MYBPC3 is classified as Pathogenic. - |
Pathogenic, criteria provided, single submitter | clinical testing | Fulgent Genetics, Fulgent Genetics | Mar 04, 2022 | - - |
Left ventricular noncompaction 10 Pathogenic:2
Likely pathogenic, criteria provided, single submitter | clinical testing | Greenwood Genetic Center Diagnostic Laboratories, Greenwood Genetic Center | Apr 26, 2022 | PVS1, PM2 - |
Likely pathogenic, criteria provided, single submitter | clinical testing | MGZ Medical Genetics Center | Jan 27, 2022 | - - |
Cardiomyopathy Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | Color Diagnostics, LLC DBA Color Health | Mar 27, 2023 | This variant causes an A to G nucleotide substitution at the -2 position of intron 1 splice acceptor site of the MYBPC3 gene. Splice site prediction tools predict that this variant may have a significant impact on RNA splicing. Although RNA studies have not been reported, this variant is expected to disrupt RNA splicing and result in an absent or non-functional protein product. This variant has been reported in over 20 individuals affected with hypertrophic cardiomyopathy (PMID: 15519027, 18957093, 21750094, 22267749, 23674513, 24510615, 27532257, 27831900) and has been shown to segregate with disease in 4 individuals from 2 families (communication with en external laboratory; ClinVar SCV000059162.6). This variant has been identified in 7/255378 chromosomes in the general population by the Genome Aggregation Database (gnomAD). Loss of MYBPC3 function is a known mechanism of disease (clinicalgenome.org). Based on the available evidence, this variant is classified as Pathogenic. - |
Pathogenic, criteria provided, single submitter | clinical testing | CHEO Genetics Diagnostic Laboratory, Children's Hospital of Eastern Ontario | Sep 08, 2021 | - - |
MYBPC3-related disorder Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | DASA | Mar 05, 2022 | The c.26-2A>G variant is located in a canonical splice-site, and it is not predicted the protein reading frame alteration, however, occur in a critical region and the variant disrupts <10% of protein - PVS1_moderate. This sequence change has been observed in affected individual(s) and ClinVar contains an entry for this variant (ClinVar ID: 42644; PMID: 15519027; PMID: 18957093; PMID: 23674513; PMID: 24510615; PMID: 22267749; PMID: 27532257) - PS4. The variant is present at low allele frequencies population databases (rs376395543 β gnomAD 0.0002741%; ABraOM no frequency - http://abraom.ib.usp.br/) - PM2_supporting. The variant co-segregated with disease in multiple affected family members (PMID: 18957093; 22267749) - PP1_strong. In summary, the currently available evidence indicates that the variant is pathogenic. - |
Pathogenic, criteria provided, single submitter | clinical testing | PreventionGenetics, part of Exact Sciences | Aug 14, 2023 | The MYBPC3 c.26-2A>G variant is predicted to disrupt the AG splice acceptor site and interfere with normal splicing. This variant has been reported in multiple patients with hypertrophic cardiomyopathy (Ehlermann et al. 2008. PubMed ID: 18957093; Witjas-Paalberends et al. 2013. PubMed ID: 23674513; Kapplinger et al. 2014. PubMed ID: 24510615). This variant is reported in 0.0052% of alleles in individuals of European (Non-Finnish) descent in gnomAD (http://gnomad.broadinstitute.org/variant/11-47373058-T-C). Variants that disrupt the consensus splice acceptor site in MYBPC3 are expected to be pathogenic. This variant is interpreted as pathogenic. - |
Primary familial hypertrophic cardiomyopathy Pathogenic:1
Likely pathogenic, no assertion criteria provided | research | CSER _CC_NCGL, University of Washington | Jun 01, 2014 | - - |
Intellectual disability Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Institute of Human Genetics, University of Leipzig Medical Center | Aug 03, 2020 | The variant c.26-2A>G, p.? was identified in an individual with neurodevelopmental disorder (NDD) and classified as Pathogenic according to ACMG guidelines. Inheritance for this variant was unknown.The variants does not (fully) explain the NDD in this individual - |
Cardiovascular phenotype Pathogenic:1
Pathogenic, criteria provided, single submitter | clinical testing | Ambry Genetics | Sep 20, 2019 | The c.26-2A>G intronic pathogenic mutation results from an A to G substitution two nucleotides upstream from coding exon 2 in the MYBPC3 gene. This mutation has been previously reported in individuals with hypertrophic cardiomyopathy (HCM) and left ventricular non-compaction (LVNC) (Page SP et al. Circ Cardiovasc Genet. 2012;5(2):156-66; Ehlermann P et al. BMC Med Genet. 2008;9:95; Van Driest SL et al. J Am Coll Cardiol. 2004;44(9):1903-10; Sedaghat-Hamedani F et al. Eur. Heart J., 2017 Dec;38:3449-3460; Walsh R et al. Genet. Med., 2017 02;19:192-203). In addition to the clinical data presented in the literature, alterations that disrupt the canonical splice site are expected to cause aberrant splicing, resulting in an abnormal protein or a transcript that is subject to nonsense-mediated mRNA decay. As such, this alteration is classified as a disease-causing mutation. - |
Computational scores
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Name
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BayesDel_addAF
Benign
T
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Uncertain
CADD
Pathogenic
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Uncertain
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Pathogenic
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Uncertain
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dbscSNV1_ADA
Pathogenic
dbscSNV1_RF
Pathogenic
SpliceAI score (max)
Details are displayed if max score is > 0.2
DS_AG_spliceai
Position offset: -8
DS_AL_spliceai
Position offset: -2
Find out detailed SpliceAI scores and Pangolin per-transcript scores at