rs72549410

Positions:

• chr3-38606058-C-T

Variant summary

Our verdict is Pathogenic. Variant got 15 ACMG points: 15P and 0B. PM2 PP2 PP3_Strong PP5_Very_Strong

The NM_001099404.2(SCN5A):​c.1231G>A​(p.Val411Met) variant causes a missense change involving the alteration of a conserved nucleotide. The variant was absent in control chromosomes in GnomAD project. In-silico tool predicts a pathogenic outcome for this variant. 13/22 in silico tools predict a damaging outcome for this variant. Variant has been reported in ClinVar as Pathogenic (★★).

• Frequency: Genomes: not found (cov: 32)
• Consequence: SCN5A NM_001099404.2 missense
• Clinical Significance: Pathogenic criteria provided, multiple submitters, no conflicts P:11 O:1
• Conservation: PhyloP100: 7.91

Genes affected

SCN5A (HGNC:10593): (sodium voltage-gated channel alpha subunit 5) The protein encoded by this gene is an integral membrane protein and tetrodotoxin-resistant voltage-gated sodium channel subunit. This protein is found primarily in cardiac muscle and is responsible for the initial upstroke of the action potential in an electrocardiogram. Defects in this gene have been associated with long QT syndrome type 3 (LQT3), atrial fibrillation, cardiomyopathy, and Brugada syndrome 1, all autosomal dominant cardiac diseases. Alternative splicing results in several transcript variants encoding different isoforms. [provided by RefSeq, May 2022]

ACMG classification

Verdict is Pathogenic. Variant got 15 ACMG points.

• PM2: Very rare variant in population databases, with high coverage
• PP2: Missense variant in gene, where missense usually causes diseases (based on misZ statistic), SCN5A. . Gene score misZ 2.7504 (greater than the threshold 3.09). Trascript score misZ 4.7729 (greater than threshold 3.09). GenCC has associacion of gene with progressive familial heart block, type 1A, Brugada syndrome, familial sick sinus syndrome, short QT syndrome, paroxysmal familial ventricular fibrillation, progressive familial heart block, long QT syndrome 3, familial atrial fibrillation, catecholaminergic polymorphic ventricular tachycardia, dilated cardiomyopathy, dilated cardiomyopathy 1E, arrhythmogenic right ventricular cardiomyopathy, Brugada syndrome 1, atrial standstill, familial isolated dilated cardiomyopathy, familial long QT syndrome, sick sinus syndrome 1.
• PP3: MetaRNN computational evidence supports a deleterious effect, 0.977
• PP5: Variant 3-38606058-C-T is Pathogenic according to our data. Variant chr3-38606058-C-T is described in ClinVar as [Pathogenic]. Clinvar id is 67651.Status of the report is criteria_provided_multiple_submitters_no_conflicts, 2 stars. Variant chr3-38606058-C-T is described in Lovd as [Pathogenic].

Transcripts

RefSeq

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	MANE	Protein	UniProt
SCN5A	NM_001099404.2	c.1231G>A	p.Val411Met	missense_variant	10/28	ENST00000413689.6	NP_001092874.1
SCN5A	NM_000335.5	c.1231G>A	p.Val411Met	missense_variant	10/28	ENST00000423572.7	NP_000326.2

Ensembl

Gene	Transcript	HGVSc	HGVSp	Effect	#exon/exons	TSL	MANE	Protein	Appris	UniProt
SCN5A	ENST00000413689.6	c.1231G>A	p.Val411Met	missense_variant	10/28	5	NM_001099404.2	ENSP00000410257	P4
SCN5A	ENST00000423572.7	c.1231G>A	p.Val411Met	missense_variant	10/28	1	NM_000335.5	ENSP00000398266	A1

Frequencies

GnomAD3 genomes Cov.: 32

GnomAD4 exome Cov.: 31

GnomAD4 genome Cov.: 32

ClinVar

Significance: Pathogenic

Submissions summary: Pathogenic:11 Other:1

Revision: criteria provided, multiple submitters, no conflicts

Submissions by phenotype

not provided Pathogenic:4

Pathogenic, criteria provided, single submitter	clinical testing	GeneDx	Jan 04, 2024	Not observed at significant frequency in large population cohorts (gnomAD); In silico analysis supports that this missense variant has a deleterious effect on protein structure/function; This variant is associated with the following publications: (PMID: 30059973, 31257342, 34228484, 22721569, 23098067, 26888838, 27485560, 28588847, 25904541, 26669661, 22885918, 15840476, 16712702, 24606995, 19716085, 23158531, 21193062, 31737537, 32383558, 34803699, 33519442, 33133318, 24709866, 32161207, 36203036, 10961955) -
Pathogenic, no assertion criteria provided	clinical testing	Joint Genome Diagnostic Labs from Nijmegen and Maastricht, Radboudumc and MUMC+	-	- -
Pathogenic, criteria provided, single submitter	clinical testing	Labcorp Genetics (formerly Invitae), Labcorp	Oct 04, 2023	This sequence change replaces valine, which is neutral and non-polar, with methionine, which is neutral and non-polar, at codon 411 of the SCN5A protein (p.Val411Met). This variant is not present in population databases (gnomAD no frequency). This missense change has been observed in individual(s) with long QT syndrome (PMID: 10961955, 15840476, 16712702, 19716085, 21193062, 23098067, 23158531, 24709866). In at least one individual the variant was observed to be de novo. ClinVar contains an entry for this variant (Variation ID: 67651). An algorithm developed to predict the effect of missense changes on protein structure and function (PolyPhen-2) suggests that this variant is likely to be disruptive. Experimental studies have shown that this missense change affects SCN5A function (PMID: 21193062). For these reasons, this variant has been classified as Pathogenic. -
Pathogenic, no assertion criteria provided	clinical testing	Clinical Genetics, Academic Medical Center	-	- -

Long QT syndrome Pathogenic:3

Pathogenic, criteria provided, single submitter	research	Dept of Medical Biology, Uskudar University	Jan 08, 2024	Criteria: PS2_Strong, PS3_Moderate, PM2, PP3 -
Pathogenic, criteria provided, single submitter	clinical testing	Molecular Diagnostic Laboratory for Inherited Cardiovascular Disease, Montreal Heart Institute	Jun 26, 2017	- -
Pathogenic, no assertion criteria provided	clinical testing	Blueprint Genetics	Jul 23, 2014	- -

Long QT syndrome 3 Pathogenic:3

Pathogenic, criteria provided, single submitter	research	Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital	Jan 01, 2013	- -
Pathogenic, criteria provided, single submitter	clinical testing	Victorian Clinical Genetics Services, Murdoch Childrens Research Institute	Nov 05, 2020	0103 - Both loss- and gain-of-function are known mechanisms of disease for this gene, where missense have been shown to both impair and improve channel current activity (OMIM, PMID: 29806494). (N) 0108 - This gene is known to be associated with both recessive and dominant disease, where recessive disease has few reports and there is no clear genotype-phenotype correlation (OMIM). (N) 0200 - Variant is predicted to result in a missense amino acid change from valine to methionine (exon 10). (N) 0251 - Variant is heterozygous. (N) 0301 - Variant is absent from gnomAD. (P) 0501 - Missense variant consistently predicted to be damaging by multiple in silico tools. (P) 0600 - Variant is located in an annotated domain or motif, (S6 of the ion transporter domain I; PMID:21193062). (N) 0705 - No comparable variants have previous evidence for pathogenicity. (N) 0801 - Strong previous evidence of pathogenicity in multiple de novo individuals with Long QT syndrome (ClinVar, LOVD, PMID:31257342, PMID:21193062). (P) 0905 - No segregation evidence has been identified for this variant. (N) 1002 - Moderate functional evidence supporting abnormal protein function, where transfected HEK293 cells demonstrated hyperpolarizing shifts in conductance voltage (PMID:21193062). (P) 1205 - Variant is maternally inherited. The variant is mosaic in this patient's mother at an allele fraction of approximately 12-14%. (N) Legend: (P) - Pathogenic, (N) - Neutral, (B) - Benign -
Pathogenic, criteria provided, single submitter	clinical testing	Center For Human Genetics And Laboratory Diagnostics, Dr. Klein, Dr. Rost And Colleagues	Feb 08, 2018	- -

Cardiovascular phenotype Pathogenic:1

Pathogenic, criteria provided, single submitter

clinical testing

Ambry Genetics

Nov 11, 2016

The p.V411M pathogenic mutation (also known as c.1231G>A), located in coding exon 9 of the SCN5A gene, results from a G to A substitution at nucleotide position 1231. The valine at codon 411 is replaced by methionine, an amino acid with highly similar properties. This alteration has been reported in multiple individuals with long QT syndrome (Priori SG et al. Circulation. 2000;102:945-7; Hofman-Bang J et al. Clin Genet. 2006;69:504-11; Kapplinger JD et al. Heart Rhythm. 2009;6:1297-303; Horne AJ et al. Heart Rhythm. 2011;8:770-7; Carrasco JI et al. Rev Esp Cardiol (Engl Ed). 2012;65:1058-9; Stattin EL et al. BMC Cardiovasc Disord. 2012;12:95; Crotti L et al. J Am Coll Cardiol. 2012;60:2515-24; Abrams DJ et al. Circulation. 2014;129:1524-9). This alteration was described as occurring de novo in two unrelated cases, and, in a third case, the alteration was detected in two affected siblings, but not in the unaffected parents (Horne AJ et al. Heart Rhythm. 2011;8:770-7; Carrasco JI et al. Rev Esp Cardiol (Engl Ed). 2012;65:1058-9; Stattin EL et al. BMC Cardiovasc Disord. 2012;12:95). Based on internal structural analysis, this alteration is anticipated to result in a decrease in structural stability (Wu J et al. Science. 2015;350(6267):aad2395In). In addition, in vitro studies have suggested that this alteration may alter channel activities (Horne AJ et al. Heart Rhythm. 2011;8:770-7). Based on the supporting evidence, this alteration is interpreted as a disease-causing mutation. -

Congenital long QT syndrome Other:1

not provided, no classification provided

literature only

Cardiovascular Biomedical Research Unit, Royal Brompton & Harefield NHS Foundation Trust

-

This variant has been reported as associated with Long QT syndrome in the following publications (PMID:10961955;PMID:15840476;PMID:16712702;PMID:19716085;PMID:21193062). This is a literature report, and does not necessarily reflect the clinical interpretation of the Imperial College / Royal Brompton Cardiovascular Genetics laboratory. -

Computational scores

Source: dbNSFP v4.3

Name	Calibrated prediction	Score	Prediction
AlphaMissense	Pathogenic	0.90
CardioboostCm	Pathogenic	1.0
BayesDel_addAF	Pathogenic	0.58	D
BayesDel_noAF	Pathogenic	0.59
CADD	Pathogenic	29
DANN	Pathogenic	1.0
DEOGEN2	Pathogenic	0.99	.;.;.;.;.;D;.;.;.
Eigen	Pathogenic	1.1
Eigen_PC	Pathogenic	1.0
FATHMM_MKL	Pathogenic	0.99	D
LIST_S2	Pathogenic	0.99	.;D;D;D;D;D;D;.;D
M_CAP	Pathogenic	0.84	D
MetaRNN	Pathogenic	0.98	D;D;D;D;D;D;D;D;D
MetaSVM	Pathogenic	1.0	D
MutationAssessor	Pathogenic	4.4	.;H;.;.;.;H;.;.;.
MutationTaster	Benign	1.0	D;D;D;D;D;D;D;D;D;D
PrimateAI	Pathogenic	0.86	D
PROVEAN	Uncertain	-2.9	D;D;D;D;D;D;D;D;D
REVEL	Pathogenic	0.95
Sift	Pathogenic	0.0	D;D;D;D;D;D;D;D;D
Sift4G	Uncertain	0.021	D;D;D;D;D;D;D;D;D
Polyphen		1.0	D;D;.;D;.;D;D;.;.
Vest4		0.99
MutPred		0.85		Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);Loss of helix (P = 0.079);
MVP		1.0
MPC		1.1
ClinPred		1.0	D
GERP RS		5.5
Varity_R		0.82
gMVP		0.94

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

LitVar

Other links and lift over

dbSNP: rs72549410; hg19: chr3-38647549;