rs727504283
Variant summary
Our verdict is Pathogenic. Variant got 19 ACMG points: 19P and 0B. PM1PM2PM5PP2PP3_StrongPP5_Very_Strong
The NM_000257.4(MYH7):c.596C>T(p.Ala199Val) 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. 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. A199T) has been classified as Likely pathogenic.
Frequency
Consequence
NM_000257.4 missense
Scores
Clinical Significance
Conservation
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ACMG classification
Verdict is Pathogenic. Variant got 19 ACMG points.
Transcripts
RefSeq
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | MANE | UniProt |
---|---|---|---|---|---|---|---|
MYH7 | NM_000257.4 | c.596C>T | p.Ala199Val | missense_variant | 7/40 | ENST00000355349.4 | |
MYH7 | NM_001407004.1 | c.596C>T | p.Ala199Val | missense_variant | 6/39 |
Ensembl
Gene | Transcript | HGVSc | HGVSp | Effect | #exon/exons | TSL | MANE | Appris | UniProt |
---|---|---|---|---|---|---|---|---|---|
MYH7 | ENST00000355349.4 | c.596C>T | p.Ala199Val | missense_variant | 7/40 | 1 | NM_000257.4 | P1 |
Frequencies
GnomAD3 genomes ? Cov.: 33
GnomAD4 exome Cov.: 34
GnomAD4 genome ? Cov.: 33
ClinVar
Submissions by phenotype
not provided Pathogenic:2
Likely pathogenic, criteria provided, single submitter | clinical testing | GeneDx | Feb 16, 2018 | The A199V likely pathogenic variant in the MYH7 gene has previously been reported in association with HCM (Alfares et al., 2015; Adler et al., 2016; Walsh et al., 2017). In addition, Pan et al. (2012) identified A199V in one patient with cardiomyopathy and found that this variant segregated with disease in >5 affected individuals within a single kindred, although specific segregation information was not provided. This variant was also identified in two unrelated individuals with childhood onset HCM referred for genetic testing at GeneDx. This variant is not observed in large population cohorts (Lek et al., 2016). Although the A199V variant is a conservative amino acid substitution, which is not likely to impact secondary protein structure as these residues share similar properties, in silico analyses, including protein predictors and evolutionary conservation, support a deleterious effect. In addition, this variant is located in the myosin motor domain, a region enriched with missense variants reported in association with HCM (Walsh et al., 2017; Kelly et al., 2018). - |
Likely pathogenic, no assertion criteria provided | clinical testing | Stanford Center for Inherited Cardiovascular Disease, Stanford University | Jan 16, 2012 | Note this variant was found in clinical genetic testing performed by one or more labs who may also submit to ClinVar. Thus any internal case data may overlap with the internal case data of other labs. The interpretation reviewed below is that of the Stanford Center for Inherited Cardiovascular Disease. p.Ala199Val (c.596C>T). Data on this variant is reviewed below. We feel there is sufficiently strong co-segregation within the patient's own family to consider it likely pathogenic. I could find no published reports of this variant. Nearby missense variants have been reported in association with disease, including p.Ala196Thr (Woo et al 2003) and p.Arg204His (Richard et al 2003). The alanine at position 199 is completely conserved across species. In silico analysis with PolyPhen 2 predicts the variant to be probably damaging, while mutation taster predicts it to be disease causing. The variant is not currently listed in the NHLBI Exome Sequencing Project dataset, which includes variant calls on ~10,000 alleles from Caucasian and African American individuals (as of December 1st, 2011). It is not listed in dbSNP or 1000 genomes (as of December 1st, 2011). - |
Hypertrophic cardiomyopathy Pathogenic:2
Pathogenic, criteria provided, single submitter | clinical testing | Invitae | May 02, 2023 | 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. Algorithms developed to predict the effect of sequence changes on RNA splicing suggest that this variant may disrupt the consensus splice site. 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 expected to disrupt MYH7 protein function. ClinVar contains an entry for this variant (Variation ID: 177692). This missense change has been observed in individuals with hypertrophic cardiomyopathy (PMID: 27532257; Invitae). This variant is not present in population databases (gnomAD no frequency). This sequence change replaces alanine, which is neutral and non-polar, with valine, which is neutral and non-polar, at codon 199 of the MYH7 protein (p.Ala199Val). - |
Likely pathogenic, criteria provided, single submitter | clinical testing | Laboratory for Molecular Medicine, Mass General Brigham Personalized Medicine | Dec 18, 2020 | The p.Ala199Val variant in MYH7 has been identified by our laboratory in at least 3 individuals with HCM and segregated with disease in several affected relatives (including 3 obligate carriers) from 1 family (Pan 2012, Alfares PMID: 25611685, Walsh 2017 PMID: 27532257, LMM unpublished data and personal communication). This variant has also been reported by other clinical laboratories in ClinVar (Variation ID: 177693) was absent from large population studies. Computational prediction tools and conservation analyses are consistent with pathogenicity. This variant lies in the head region of the protein and missense variants in this region are statistically more likely to be disease-associated (Walsh 2017 PMID 27532257). In summary, although additional studies are required to fully establish its clinical significance, this variant meets criteria to be classified as likely pathogenic for autosomal dominant HCM. ACMG/AMP Criteria applied: PM2_Supporting, PS4_Supporting, PP1_Strong, PP3, PM1. - |
Cardiovascular phenotype Pathogenic:1
Likely pathogenic, criteria provided, single submitter | clinical testing | Ambry Genetics | Apr 23, 2024 | The p.A199V variant (also known as c.596C>T), located in coding exon 5 of the MYH7 gene, results from a C to T substitution at nucleotide position 596. The alanine at codon 199 is replaced by valine, an amino acid with similar properties. This alteration is located in the myosin head domain, which contains a statistically significant clustering of pathogenic missense variants (Homburger JR et al. Proc Natl Acad Sci U S A, 2016 06;113:6701-6; Walsh R et al. Genet Med, 2017 02;19:192-203; Ambry internal data). This alteration has been reported in individuals with hypertrophic cardiomyopathy (HCM) (Adler A et al. Circ Arrhythm Electrophysiol, 2016 Jan;9:e003440; Walsh R et al. Genet Med, 2017 Feb;19:192-203; Ho CY et al. Circulation, 2018 Oct;138:1387-1398; Sepp R et al. Diagnostics (Basel), 2022 May;12:[ePub ahead of print]). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). Based on the majority of available evidence to date, this variant is likely to be pathogenic. - |
Computational scores
Source:
Splicing
Find out detailed SpliceAI scores and Pangolin per-transcript scores at