Our verdict is Benign. The variant received -20 ACMG points: 0P and 20B. BP4_StrongBP6_Very_StrongBA1
The NM_002471.4(MYH6):c.4778A>T(p.Gln1593Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0102 in 1,612,108 control chromosomes in the GnomAD database, including 592 homozygotes. In-silico tool predicts a benign outcome for this variant. 16/21 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Benign (★★).
MYH6 (HGNC:7576): (myosin heavy chain 6) Cardiac muscle myosin is a hexamer consisting of two heavy chain subunits, two light chain subunits, and two regulatory subunits. This gene encodes the alpha heavy chain subunit of cardiac myosin. The gene is located approximately 4kb downstream of the gene encoding the beta heavy chain subunit of cardiac myosin. Mutations in this gene cause familial hypertrophic cardiomyopathy and atrial septal defect 3. [provided by RefSeq, Feb 2017]
MYH6 Gene-Disease associations (from GenCC):
hypertrophic cardiomyopathy 14
Inheritance: AD Classification: STRONG, LIMITED Submitted by: Labcorp Genetics (formerly Invitae), PanelApp Australia, Laboratory for Molecular Medicine
Keppen-Lubinsky syndrome
Inheritance: AD Classification: MODERATE Submitted by: Illumina
familial isolated dilated cardiomyopathy
Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
atrial septal defect 3
Inheritance: AD Classification: LIMITED Submitted by: G2P
dilated cardiomyopathy
Inheritance: AD Classification: LIMITED Submitted by: ClinGen
hypertrophic cardiomyopathy
Inheritance: AD Classification: LIMITED Submitted by: ClinGen
Our verdict: Benign. The variant received -20 ACMG points.
BP4
Computational evidence support a benign effect (MetaRNN=0.0018672347).
BP6
Variant 14-23386496-T-A is Benign according to our data. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr14-23386496-T-A is described in CliVar as Benign. Clinvar id is 44520.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars.
BA1
GnomAd4 highest subpopulation (AFR) allele frequency at 95% confidence interval = 0.115 is higher than 0.05.
⚠️ The allele balance in gnomAD version 4 Exomes is significantly skewed from the expected value of 0.5.
African (AFR)
AF:
0.111
AC:
3666
AN:
32932
American (AMR)
AF:
0.00957
AC:
427
AN:
44624
Ashkenazi Jewish (ASJ)
AF:
0.00126
AC:
33
AN:
26128
East Asian (EAS)
AF:
0.0124
AC:
492
AN:
39672
South Asian (SAS)
AF:
0.00632
AC:
544
AN:
86120
European-Finnish (FIN)
AF:
0.000281
AC:
15
AN:
53418
Middle Eastern (MID)
AF:
0.00574
AC:
33
AN:
5748
European-Non Finnish (NFE)
AF:
0.00433
AC:
4810
AN:
1111002
Other (OTH)
AF:
0.0117
AC:
708
AN:
60270
⚠️ The allele balance in gnomAD4 Exomes is highly skewed from 0.5 (p-value = 0.000000), which strongly suggests a high chance of mosaicism in these individuals.
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.351
Heterozygous variant carriers
0
541
1082
1623
2164
2705
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Age Distribution
Exome Het
Exome Hom
Variant carriers
0
268
536
804
1072
1340
<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:
0.0370
AC:
5637
AN:
152194
Hom.:
311
Cov.:
31
AF XY:
0.0356
AC XY:
2650
AN XY:
74410
show subpopulations
African (AFR)
AF:
0.118
AC:
4898
AN:
41484
American (AMR)
AF:
0.0144
AC:
221
AN:
15302
Ashkenazi Jewish (ASJ)
AF:
0.00173
AC:
6
AN:
3470
East Asian (EAS)
AF:
0.0167
AC:
86
AN:
5164
South Asian (SAS)
AF:
0.00809
AC:
39
AN:
4820
European-Finnish (FIN)
AF:
0.000188
AC:
2
AN:
10628
Middle Eastern (MID)
AF:
0.0170
AC:
5
AN:
294
European-Non Finnish (NFE)
AF:
0.00479
AC:
326
AN:
68004
Other (OTH)
AF:
0.0255
AC:
54
AN:
2116
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.476
Heterozygous variant carriers
0
228
456
685
913
1141
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Age Distribution
Genome Het
Genome Hom
Variant carriers
0
56
112
168
224
280
<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:
0.0131
Hom.:
19
Bravo
AF:
0.0429
TwinsUK
AF:
0.00485
AC:
18
ALSPAC
AF:
0.00519
AC:
20
ESP6500AA
AF:
0.0570
AC:
251
ESP6500EA
AF:
0.00337
AC:
29
ExAC
AF:
0.0149
AC:
1805
ClinVar
Significance: Benign
Submissions summary: Benign:11
Revision: criteria provided, multiple submitters, no conflicts
Genome Diagnostics Laboratory, University Medical Center Utrecht
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing
- -
Jun 24, 2013
Biesecker Lab/Clinical Genomics Section, National Institutes of Health
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:research
- -
-
Clinical Genetics, Academic Medical Center
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing
- -
Jun 15, 2016
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
- -
-
Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+
Significance:Benign
Review Status:no assertion criteria provided
Collection Method:clinical testing
- -
Oct 24, 2016
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. -
Dec 27, 2011
Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing
- -
Hypertrophic cardiomyopathy 14Benign:1
Feb 04, 2025
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:clinical testing
- -
not providedBenign:1
-
Breakthrough Genomics, Breakthrough Genomics
Significance:Benign
Review Status:criteria provided, single submitter
Collection Method:not provided
- -
Cardiovascular phenotypeBenign:1
Jul 08, 2015
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: seen in unaffected individuals, 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. -