rs542532555

Variant summary

Our verdict is Benign. The variant received -8 ACMG points: 0P and 8B. BP4_StrongBS2

The NM_005477.3(HCN4):​c.520C>T​(p.Pro174Ser) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.0001 in 1,558,488 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. 15/22 in silico tools predict a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Another variant affecting the same amino acid position, but resulting in a different missense (i.e. P174A) has been classified as Uncertain significance.

Frequency

Genomes: 𝑓 0.000072 ( 0 hom., cov: 32)
Exomes 𝑓: 0.00010 ( 0 hom. )

Consequence

HCN4
NM_005477.3 missense

Scores

1
2
15

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:6

Conservation

PhyloP100: 0.0150

Publications

1 publications found
Variant links:
Genes affected
HCN4 (HGNC:16882): (hyperpolarization activated cyclic nucleotide gated potassium channel 4) This gene encodes a member of the hyperpolarization-activated cyclic nucleotide-gated potassium channels. The encoded protein shows slow kinetics of activation and inactivation, and is necessary for the cardiac pacemaking process. This channel may also mediate responses to sour stimuli. Mutations in this gene have been linked to sick sinus syndrome 2, also known as atrial fibrillation with bradyarrhythmia or familial sinus bradycardia. Two pseudogenes have been identified on chromosome 15. [provided by RefSeq, Oct 2008]
HCN4 Gene-Disease associations (from GenCC):
  • sick sinus syndrome 2, autosomal dominant
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: ClinGen, Genomics England PanelApp, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • Brugada syndrome 8
    Inheritance: AD Classification: MODERATE, LIMITED Submitted by: Genomics England PanelApp, Ambry Genetics, Labcorp Genetics (formerly Invitae)
  • familial sick sinus syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • Brugada syndrome 1
    Inheritance: AD Classification: NO_KNOWN Submitted by: ClinGen

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Benign. The variant received -8 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.04579982).
BS2
High AC in GnomAd4 at 11 AD gene.

Variant Effect in Transcripts

ACMG analysis was done for transcript: NM_005477.3. You can select a different transcript below to see updated ACMG assignments.

RefSeq Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
HCN4
NM_005477.3
MANE Select
c.520C>Tp.Pro174Ser
missense
Exon 1 of 8NP_005468.1Q9Y3Q4

Ensembl Transcripts

Sel.
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
HCN4
ENST00000261917.4
TSL:1 MANE Select
c.520C>Tp.Pro174Ser
missense
Exon 1 of 8ENSP00000261917.3Q9Y3Q4

Frequencies

GnomAD3 genomes
AF:
0.0000725
AC:
11
AN:
151646
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.0000966
Gnomad AMI
AF:
0.00
Gnomad AMR
AF:
0.00
Gnomad ASJ
AF:
0.00
Gnomad EAS
AF:
0.00
Gnomad SAS
AF:
0.00
Gnomad FIN
AF:
0.00
Gnomad MID
AF:
0.00
Gnomad NFE
AF:
0.000103
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.0000990
AC:
16
AN:
161616
AF XY:
0.000144
show subpopulations
Gnomad AFR exome
AF:
0.000122
Gnomad AMR exome
AF:
0.00
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.000219
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.000103
AC:
145
AN:
1406734
Hom.:
0
Cov.:
32
AF XY:
0.0000818
AC XY:
57
AN XY:
696662
show subpopulations
African (AFR)
AF:
0.0000310
AC:
1
AN:
32254
American (AMR)
AF:
0.00
AC:
0
AN:
39396
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25348
East Asian (EAS)
AF:
0.00
AC:
0
AN:
37200
South Asian (SAS)
AF:
0.00
AC:
0
AN:
82250
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
35178
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
4316
European-Non Finnish (NFE)
AF:
0.000129
AC:
141
AN:
1092228
Other (OTH)
AF:
0.0000512
AC:
3
AN:
58564
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.485
Heterozygous variant carriers
0
8
16
25
33
41
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome Het
Variant carriers
0
10
20
30
40
50
<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:
0.0000725
AC:
11
AN:
151754
Hom.:
0
Cov.:
32
AF XY:
0.000108
AC XY:
8
AN XY:
74184
show subpopulations
African (AFR)
AF:
0.0000964
AC:
4
AN:
41510
American (AMR)
AF:
0.00
AC:
0
AN:
15254
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3466
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5138
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4832
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10388
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
292
European-Non Finnish (NFE)
AF:
0.000103
AC:
7
AN:
67858
Other (OTH)
AF:
0.00
AC:
0
AN:
2104
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.525
Heterozygous variant carriers
0
1
2
3
4
5
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Genome Het
Variant carriers
0
2
4
6
8
10
<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:
0.00
Hom.:
0
Bravo
AF:
0.0000529
ExAC
AF:
0.0000645
AC:
7

ClinVar

ClinVar submissions
Significance:Uncertain significance
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
1
-
Brugada syndrome 8 (1)
-
1
-
Cardiovascular phenotype (1)
-
1
-
HCN4-related disorder (1)
-
1
-
Hypertrophic cardiomyopathy (1)
-
1
-
not provided (1)
-
1
-
Sick sinus syndrome 2, autosomal dominant;C2751083:Brugada syndrome 8;C5561983:Epilepsy, idiopathic generalized, susceptibility to, 18 (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.067
BayesDel_addAF
Benign
-0.23
T
BayesDel_noAF
Benign
-0.28
CADD
Benign
16
DANN
Benign
0.96
DEOGEN2
Benign
0.23
T
Eigen
Benign
-0.65
Eigen_PC
Benign
-0.48
FATHMM_MKL
Benign
0.23
N
LIST_S2
Benign
0.55
T
M_CAP
Pathogenic
0.38
D
MetaRNN
Benign
0.046
T
MetaSVM
Uncertain
-0.22
T
MutationAssessor
Benign
0.0
N
PhyloP100
0.015
PrimateAI
Uncertain
0.77
T
PROVEAN
Benign
-0.030
N
REVEL
Benign
0.19
Sift
Benign
0.65
T
Sift4G
Benign
0.16
T
Polyphen
0.0
B
Vest4
0.053
MutPred
0.17
Gain of phosphorylation at P174 (P = 0.0094)
MVP
0.76
MPC
1.1
ClinPred
0.024
T
GERP RS
2.8
Varity_R
0.043
gMVP
0.22
Mutation Taster
=93/7
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: rs542532555; hg19: chr15-73660092; API