rs763031434

Variant summary

Our verdict is Uncertain significance. The variant received 0 ACMG points: 1P and 1B. PP2BS2_Supporting

The NM_000238.4(KCNH2):​c.2606C>T​(p.Pro869Leu) variant causes a missense change. The variant allele was found at a frequency of 0.00000559 in 1,608,732 control chromosomes in the GnomAD database, with no homozygous occurrence. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. P869P) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000013 ( 0 hom., cov: 31)
Exomes 𝑓: 0.0000048 ( 0 hom. )

Consequence

KCNH2
NM_000238.4 missense

Scores

5
10
5

Clinical Significance

Uncertain significance criteria provided, multiple submitters, no conflicts U:7

Conservation

PhyloP100: 5.02

Publications

0 publications found
Variant links:
Genes affected
KCNH2 (HGNC:6251): (potassium voltage-gated channel subfamily H member 2) This gene encodes a component of a voltage-activated potassium channel found in cardiac muscle, nerve cells, and microglia. Four copies of this protein interact with one copy of the KCNE2 protein to form a functional potassium channel. Mutations in this gene can cause long QT syndrome type 2 (LQT2). Transcript variants encoding distinct isoforms have been identified. [provided by RefSeq, May 2022]
KCNH2 Gene-Disease associations (from GenCC):
  • long QT syndrome
    Inheritance: AD Classification: DEFINITIVE Submitted by: ClinGen
  • long QT syndrome 2
    Inheritance: AD Classification: DEFINITIVE, STRONG Submitted by: Labcorp Genetics (formerly Invitae), Ambry Genetics, G2P
  • short QT syndrome
    Inheritance: AD Classification: DEFINITIVE, SUPPORTIVE Submitted by: Orphanet, ClinGen
  • short QT syndrome type 1
    Inheritance: AD Classification: DEFINITIVE, STRONG, MODERATE Submitted by: Labcorp Genetics (formerly Invitae), G2P, Ambry Genetics
  • Brugada syndrome
    Inheritance: AD Classification: MODERATE, NO_KNOWN Submitted by: ClinGen, Genomics England PanelApp

Genome browser will be placed here

ACMG classification

Classification was made for transcript

Our verdict: Uncertain_significance. The variant received 0 ACMG points.

PP2
Missense variant in the gene, where a lot of missense mutations are associated with disease in ClinVar. The gene has 158 curated pathogenic missense variants (we use a threshold of 10). The gene has 38 curated benign missense variants. Gene score misZ: 3.3724 (above the threshold of 3.09). Trascript score misZ: 2.4846 (below the threshold of 3.09). GenCC associations: The gene is linked to long QT syndrome 2, Brugada syndrome, short QT syndrome type 1, short QT syndrome, long QT syndrome.
BS2
High AC in GnomAdExome4 at 7 AD gene. Variant has AC lower than other variant known as pathogenic in the gene, so the strength is limited to Supporting.

Transcripts

RefSeq

Gene Transcript HGVSc HGVSp Effect Exon rank MANE Protein UniProt
KCNH2NM_000238.4 linkc.2606C>T p.Pro869Leu missense_variant Exon 11 of 15 ENST00000262186.10 NP_000229.1 Q12809-1Q15BH2A0A090N8Q0

Ensembl

Gene Transcript HGVSc HGVSp Effect Exon rank TSL MANE Protein Appris UniProt
KCNH2ENST00000262186.10 linkc.2606C>T p.Pro869Leu missense_variant Exon 11 of 15 1 NM_000238.4 ENSP00000262186.5 Q12809-1

Frequencies

GnomAD3 genomes
AF:
0.0000132
AC:
2
AN:
151622
Hom.:
0
Cov.:
31
show subpopulations
Gnomad AFR
AF:
0.0000484
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:
0.00
Gnomad OTH
AF:
0.00
GnomAD2 exomes
AF:
0.00000799
AC:
2
AN:
250212
AF XY:
0.00000738
show subpopulations
Gnomad AFR exome
AF:
0.00
Gnomad AMR exome
AF:
0.0000289
Gnomad ASJ exome
AF:
0.00
Gnomad EAS exome
AF:
0.00
Gnomad FIN exome
AF:
0.00
Gnomad NFE exome
AF:
0.00000885
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000480
AC:
7
AN:
1457110
Hom.:
0
Cov.:
37
AF XY:
0.00000414
AC XY:
3
AN XY:
724928
show subpopulations
African (AFR)
AF:
0.00
AC:
0
AN:
33348
American (AMR)
AF:
0.0000225
AC:
1
AN:
44542
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
25980
East Asian (EAS)
AF:
0.00
AC:
0
AN:
39410
South Asian (SAS)
AF:
0.00
AC:
0
AN:
86210
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
52604
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
5752
European-Non Finnish (NFE)
AF:
0.00000361
AC:
4
AN:
1109176
Other (OTH)
AF:
0.0000333
AC:
2
AN:
60088
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.432
Heterozygous variant carriers
0
1
2
2
3
4
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance

Age Distribution

Exome 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
GnomAD4 genome
AF:
0.0000132
AC:
2
AN:
151622
Hom.:
0
Cov.:
31
AF XY:
0.0000270
AC XY:
2
AN XY:
74052
show subpopulations
African (AFR)
AF:
0.0000484
AC:
2
AN:
41294
American (AMR)
AF:
0.00
AC:
0
AN:
15224
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3468
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5124
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4770
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10512
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
316
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
67918
Other (OTH)
AF:
0.00
AC:
0
AN:
2084
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.450
Heterozygous variant carriers
0
0
1
1
2
2
0.00
0.20
0.40
0.60
0.80
0.95
Allele balance
Alfa
AF:
0.0000267
Hom.:
0
Bravo
AF:
0.0000151
ExAC
AF:
0.00000824
AC:
1
EpiCase
AF:
0.00
EpiControl
AF:
0.0000593

ClinVar

Significance: Uncertain significance
Submissions summary: Uncertain:7
Revision: criteria provided, multiple submitters, no conflicts
LINK: link

Submissions by phenotype

Long QT syndrome Uncertain:2
Aug 13, 2024
All of Us Research Program, National Institutes of Health
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces proline with leucine at codon 869 of the KCNH2 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function (internally defined REVEL score threshold >= 0.7, PMID: 27666373). Splice site prediction tools suggest that this variant may not impact RNA splicing. To our knowledge, functional studies have not been performed for this variant. This variant has not been reported in individuals affected with cardiovascular disorders in the literature. This variant has been identified in 3/281566 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Nov 18, 2024
Labcorp Genetics (formerly Invitae), Labcorp
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This sequence change replaces proline, which is neutral and non-polar, with leucine, which is neutral and non-polar, at codon 869 of the KCNH2 protein (p.Pro869Leu). This variant is present in population databases (rs763031434, gnomAD 0.004%). This variant has not been reported in the literature in individuals affected with KCNH2-related conditions. ClinVar contains an entry for this variant (Variation ID: 200473). 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 tolerated. In summary, the available evidence is currently insufficient to determine the role of this variant in disease. Therefore, it has been classified as a Variant of Uncertain Significance. -

Brugada syndrome 1 Uncertain:1
Feb 09, 2017
Center for Human Genetics, University of Leuven
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

ACMG score unknown significance -

not provided Uncertain:1
Jun 10, 2013
GeneDx
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The Pro869Leu variant in the KCNH2 gene has not been reported as a disease-causing mutation or as a benign polymorphism to our knowledge. Pro869Leu results in the removal of a sterically constrained Proline residue at a position that is conserved across species. Other nearby missense mutations have been reported (Ile858Thr, Asn861His, Asn861Ile, Asp864Gly, Gly873Ser, Gly879Arg) in association with arrhythmia, further supporting the functional importance of this region of the protein. In addition, the Pro869Leu variant was not observed in approximately 6,000 individuals of European and African American ancestry in the NHLBI Exome Sequencing Project, indicating it is not a common benign variant in these populations. However, in silico analysis predicts Pro869Leu is benign to the protein structure/function.With the clinical and molecular information available at this time, we cannot definitively determine if Pro869Leu in the KCNH2 gene is a disease-causing mutation or a rare benign variant. The variant is found in POSTMORTEM,LQT panel(s). -

Cardiovascular phenotype Uncertain:1
Mar 14, 2025
Ambry Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

The p.P869L variant (also known as c.2606C>T), located in coding exon 11 of the KCNH2 gene, results from a C to T substitution at nucleotide position 2606. The proline at codon 869 is replaced by leucine, an amino acid with similar properties. This alteration has been reported in a cardiomyopathy and primary arrhythmia syndrome cohort; however, clinical details were limited and additional alterations in other cardiac-related genes were identified in some cases (Robyns T et al. Eur J Hum Genet, 2017 Dec;25:1313-1323). Additionally, this alteration was detected in an epilepsy cohort (Li X et al. Ann Hum Genet, 2020 Mar;84:161-168). This amino acid position is highly conserved in available vertebrate species. In addition, this alteration is predicted to be deleterious by in silico analysis. Since supporting evidence is limited at this time, the clinical significance of this alteration remains unclear. -

Short QT syndrome type 1;C3150943:Long QT syndrome 2 Uncertain:1
Sep 16, 2021
Fulgent Genetics, Fulgent Genetics
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

- -

Cardiac arrhythmia Uncertain:1
Mar 19, 2024
Color Diagnostics, LLC DBA Color Health
Significance:Uncertain significance
Review Status:criteria provided, single submitter
Collection Method:clinical testing

This missense variant replaces proline with leucine at codon 869 of the KCNH2 protein. Computational prediction suggests that this variant may have deleterious impact on protein structure and function. To our knowledge, functional studies have not been reported for this variant. This variant has not been reported in individuals affected with KCNH2-related disorders in the literature. This variant has been identified in 3/281566 chromosomes in the general population by the Genome Aggregation Database (gnomAD). The available evidence is insufficient to determine the role of this variant in disease conclusively. Therefore, this variant is classified as a Variant of Uncertain Significance. -

Computational scores

Source: dbNSFP v4.3

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Uncertain
0.41
CardioboostArm
Benign
0.00067
BayesDel_addAF
Pathogenic
0.35
D
BayesDel_noAF
Pathogenic
0.27
CADD
Uncertain
26
DANN
Uncertain
0.99
DEOGEN2
Uncertain
0.69
.;D
Eigen
Uncertain
0.21
Eigen_PC
Uncertain
0.26
FATHMM_MKL
Uncertain
0.90
D
LIST_S2
Uncertain
0.91
D;D
M_CAP
Pathogenic
0.77
D
MetaRNN
Uncertain
0.43
T;T
MetaSVM
Pathogenic
0.99
D
MutationAssessor
Benign
1.8
.;L
PhyloP100
5.0
PrimateAI
Uncertain
0.77
T
PROVEAN
Uncertain
-3.3
D;D
REVEL
Pathogenic
0.78
Sift
Benign
0.75
T;T
Sift4G
Benign
0.33
T;T
Polyphen
0.027
B;P
Vest4
0.44
MutPred
0.33
.;Loss of disorder (P = 0.0397);
MVP
0.97
MPC
0.30
ClinPred
0.96
D
GERP RS
4.1
RBP_binding_hub_radar
0.0
RBP_regulation_power_radar
1.9
Varity_R
0.18
gMVP
0.82
Mutation Taster
=21/79
disease causing

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: rs763031434; hg19: chr7-150645618; COSMIC: COSV100060723; COSMIC: COSV100060723; API