rs397516258
Variant summary
Our verdict is Pathogenic. The variant received 12 ACMG points: 13P and 1B. PM1PM2PP2PP5_Very_StrongBP4
The NM_000257.4(MYH7):c.602T>C(p.Ile201Thr) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.000000684 in 1,461,892 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 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. I201F) has been classified as Uncertain significance.
Frequency
Consequence
NM_000257.4 missense
Scores
Clinical Significance
Conservation
Publications
- dilated cardiomyopathyInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
 - dilated cardiomyopathy 1SInheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics
 - hypertrophic cardiomyopathyInheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
 - hypertrophic cardiomyopathy 1Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: PanelApp Australia, Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics
 - MYH7-related skeletal myopathyInheritance: AD Classification: DEFINITIVE, STRONG, SUPPORTIVE Submitted by: Orphanet, Labcorp Genetics (formerly Invitae), ClinGen, Ambry Genetics
 - myopathy, myosin storage, autosomal recessiveInheritance: AR Classification: STRONG, MODERATE Submitted by: Ambry Genetics, Labcorp Genetics (formerly Invitae)
 - myopathy, myosin storage, autosomal dominantInheritance: AD Classification: MODERATE Submitted by: Ambry Genetics
 - congenital myopathy 7A, myosin storage, autosomal dominantInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - Ebstein anomalyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - familial isolated dilated cardiomyopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - hyaline body myopathyInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - left ventricular noncompactionInheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
 - arrhythmogenic right ventricular cardiomyopathyInheritance: AD Classification: LIMITED Submitted by: ClinGen
 - congenital heart diseaseInheritance: AD Classification: LIMITED Submitted by: ClinGen
 
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ACMG classification
Our verdict: Pathogenic. The variant received 12 ACMG points.
Transcripts
RefSeq
Ensembl
| Gene | Transcript | HGVSc | HGVSp | Effect | Exon rank | TSL | MANE | Protein | Appris | UniProt | 
|---|---|---|---|---|---|---|---|---|---|---|
| MYH7 | ENST00000355349.4  | c.602T>C | p.Ile201Thr | missense_variant | Exon 7 of 40 | 1 | NM_000257.4 | ENSP00000347507.3 | ||
| MYH7 | ENST00000713768.1  | c.602T>C | p.Ile201Thr | missense_variant | Exon 7 of 41 | ENSP00000519070.1 | ||||
| MYH7 | ENST00000713769.1  | c.602T>C | p.Ile201Thr | missense_variant | Exon 6 of 39 | ENSP00000519071.1 | 
Frequencies
GnomAD3 genomes  Cov.: 33 
GnomAD4 exome  AF:  6.84e-7  AC: 1AN: 1461892Hom.:  0  Cov.: 34 AF XY:  0.00000138  AC XY: 1AN XY: 727248 show subpopulations 
Age Distribution
GnomAD4 genome  Cov.: 33 
ClinVar
Submissions by phenotype
not provided    Pathogenic:4 
Reported in ClinVar (ClinVar Variant ID 43093; ClinVar); Not observed in large population cohorts (gnomAD); In silico analysis supports that this missense variant does not alter protein structure/function; This variant is associated with the following publications: (PMID: 16416045, 22337857, 25714468, 27802374, 21424860, 18555187, 24474197, 15769782, 28606303, 24503780, 29666183, 27532257, 31317183, 33500567, 33906374, 29300372, 31737537, 30847666, 26582918, 32013205) -
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Dilated cardiomyopathy 1S    Pathogenic:2 
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Based on the classification scheme VCGS_Germline_v1.3.4, this variant is classified as Likely Pathogenic. Following criteria are met: 0105 - The mechanism of disease for this gene is not clearly established however, missense variants have been proposed to act in a dominant negative manner (PMID: 24714796). (I) 0108 - This gene is associated with both recessive and dominant disease (OMIM). (I) 0200 - Variant is predicted to result in a missense amino acid change from isoleucine to threonine (I) 0251 - This variant is heterozygous. (I) 0301 - Variant is absent from gnomAD (both v2 and v3). (SP) 0309 - An alternative amino acid change at the same position has been observed in gnomAD (v2: 2 heterozygotes, 0 homozygotes). (I) 0502 - Missense variant with conflicting in silico predictions and uninformative conservation. (I) 0504 - Same amino acid change has been observed in placental mammals. (SB) 0601 - Variant is located in the well-established functional myosin_head domain (PMID: 29300372). (SP) 0705 - No comparable missense variants have previous evidence for pathogenicity. (I) 0801 - This variant has strong previous evidence of pathogenicity in unrelated individuals. It has been previously reported as likely pathogenic in multiple patients with DCM (ClinVar, PMID: 15769782, 24503780, 30847666, 32013205). (SP) 1002 - This variant has moderate functional evidence supporting abnormal protein function. Functional studies show that this variant causes a deficit in force generation and force-holding capacity due to the reduced occupancy of the force-holding state (PMID: 29666183). (SP) 1208 - Inheritance information for this variant is not currently available in this individual. (I) Legend: (SP) - Supporting pathogenic, (I) - Information, (SB) - Supporting benign -
Cardiomyopathy    Pathogenic:1 
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Primary familial dilated cardiomyopathy    Pathogenic:1 
Variant summary: MYH7 c.602T>C (p.Ile201Thr) results in a non-conservative amino acid change located in the Myosin. Large ATPases (IPR001609) of the encoded protein sequence. Three of five in-silico tools predict a benign effect of the variant on protein function. The variant was absent in 251942 control chromosomes. c.602T>C has been reported in the literature in individuals affected with Dilated Cardiomyopathy (e.g. Villard_2005, Pugh_2014, Franaszczyk_2020), shown to segregate with disease and also observed de novo in another case. These data indicate that the variant is likely to be associated with disease. To our knowledge, no experimental evidence demonstrating an impact on protein function has been reported. The following publications have been ascertained in the context of this evaluation (PMID: 15769782, 24503780, 32013205). ClinVar contains an entry for this variant (Variation ID: 43093). Based on the evidence outlined above, the variant was classified as pathogenic. -
Primary dilated cardiomyopathy    Pathogenic:1 
proposed classification - variant undergoing re-assessment, contact laboratory -
Hypertrophic cardiomyopathy    Pathogenic:1 
This sequence change replaces isoleucine, which is neutral and non-polar, with threonine, which is neutral and polar, at codon 201 of the MYH7 protein (p.Ile201Thr). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individuals with dilated cardiomyopathy (PMID: 15769782, 27532257; Invitae). It has also been observed to segregate with disease in related individuals. ClinVar contains an entry for this variant (Variation ID: 43093). Advanced modeling of protein sequence and biophysical properties (such as structural, functional, and spatial information, amino acid conservation, physicochemical variation, residue mobility, and thermodynamic stability) performed at Invitae indicates that this missense variant is not expected to disrupt MYH7 protein function with a negative predictive value of 95%. This variant is found within a region of MYH7 between codons 181 and 937 that contains the majority of the myosin head domain. Missense variants in this region have been shown to be significantly overrepresented in individuals with hypertrophic cardiomyopathy (PMID: 27532257). For these reasons, this variant has been classified as Pathogenic. -
Computational scores
Source: 
Splicing
 Find out detailed SpliceAI scores and Pangolin per-transcript scores at