rs772764704

Variant summary

Our verdict is Likely benign. The variant received -6 ACMG points: 0P and 6B. BP4_ModerateBS2

The NM_005477.3(HCN4):​c.394A>C​(p.Ile132Leu) variant causes a missense change involving the alteration of a non-conserved nucleotide. The variant allele was found at a frequency of 0.00000892 in 1,345,682 control chromosomes in the GnomAD database, with no homozygous occurrence. In-silico tool predicts a benign outcome for this variant. Variant has been reported in ClinVar as Uncertain significance (★★). Synonymous variant affecting the same amino acid position (i.e. I132I) has been classified as Likely benign.

Frequency

Genomes: 𝑓 0.000040 ( 0 hom., cov: 32)
Exomes 𝑓: 0.0000050 ( 0 hom. )

Consequence

HCN4
NM_005477.3 missense

Scores

2
5
11

Clinical Significance

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

Conservation

PhyloP100: 1.57

Publications

0 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: STRONG Submitted by: Genomics England PanelApp, Labcorp Genetics (formerly Invitae), Ambry Genetics
  • Brugada syndrome 8
    Inheritance: AD Classification: MODERATE, LIMITED Submitted by: Ambry Genetics, Genomics England PanelApp, Labcorp Genetics (formerly Invitae)
  • familial sick sinus syndrome
    Inheritance: AD Classification: SUPPORTIVE Submitted by: Orphanet
  • familial thoracic aortic aneurysm and aortic dissection
    Inheritance: AD Classification: LIMITED Submitted by: ClinGen
  • 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: Likely_benign. The variant received -6 ACMG points.

BP4
Computational evidence support a benign effect (MetaRNN=0.089181304).
BS2
High AC in GnomAd4 at 6 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

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
HCN4
NM_005477.3
MANE Select
c.394A>Cp.Ile132Leu
missense
Exon 1 of 8NP_005468.1

Ensembl Transcripts

Selected
GeneTranscriptTagsHGVScHGVSpEffectExon RankProteinUniProt
HCN4
ENST00000261917.4
TSL:1 MANE Select
c.394A>Cp.Ile132Leu
missense
Exon 1 of 8ENSP00000261917.3

Frequencies

GnomAD3 genomes
AF:
0.0000397
AC:
6
AN:
151128
Hom.:
0
Cov.:
32
show subpopulations
Gnomad AFR
AF:
0.000145
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:
0.0000131
AC:
1
AN:
76208
AF XY:
0.00
show subpopulations
Gnomad AFR exome
AF:
0.000394
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:
0.00
Gnomad OTH exome
AF:
0.00
GnomAD4 exome
AF:
0.00000502
AC:
6
AN:
1194554
Hom.:
0
Cov.:
31
AF XY:
0.00000687
AC XY:
4
AN XY:
582062
show subpopulations
African (AFR)
AF:
0.0000400
AC:
1
AN:
25010
American (AMR)
AF:
0.00
AC:
0
AN:
20292
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
18694
East Asian (EAS)
AF:
0.0000372
AC:
1
AN:
26914
South Asian (SAS)
AF:
0.00
AC:
0
AN:
46960
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
26728
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
3356
European-Non Finnish (NFE)
AF:
0.00000102
AC:
1
AN:
978828
Other (OTH)
AF:
0.0000628
AC:
3
AN:
47772
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.492
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:
0.0000397
AC:
6
AN:
151128
Hom.:
0
Cov.:
32
AF XY:
0.0000407
AC XY:
3
AN XY:
73786
show subpopulations
African (AFR)
AF:
0.000145
AC:
6
AN:
41296
American (AMR)
AF:
0.00
AC:
0
AN:
15190
Ashkenazi Jewish (ASJ)
AF:
0.00
AC:
0
AN:
3456
East Asian (EAS)
AF:
0.00
AC:
0
AN:
5126
South Asian (SAS)
AF:
0.00
AC:
0
AN:
4826
European-Finnish (FIN)
AF:
0.00
AC:
0
AN:
10270
Middle Eastern (MID)
AF:
0.00
AC:
0
AN:
312
European-Non Finnish (NFE)
AF:
0.00
AC:
0
AN:
67664
Other (OTH)
AF:
0.00
AC:
0
AN:
2076
Allele Balance Distribution
Red line indicates average allele balance
Average allele balance: 0.575
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

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:
0.0000491
ExAC
AF:
0.00000953
AC:
1

ClinVar

ClinVar submissions as Germline

Significance:Uncertain significance
Revision:criteria provided, multiple submitters, no conflicts
View on ClinVar
Pathogenic
VUS
Benign
Condition
-
3
-
not provided (3)
-
1
-
Brugada syndrome 8 (1)
-
1
-
Cardiovascular phenotype (1)
-
1
-
HCN4-related disorder (1)

Computational scores

Source: dbNSFP v4.9

Name
Calibrated prediction
Score
Prediction
AlphaMissense
Benign
0.30
BayesDel_addAF
Benign
-0.11
T
BayesDel_noAF
Uncertain
-0.080
CADD
Benign
22
DANN
Benign
0.94
DEOGEN2
Benign
0.25
T
Eigen
Benign
-0.36
Eigen_PC
Benign
-0.28
FATHMM_MKL
Uncertain
0.83
D
LIST_S2
Benign
0.69
T
M_CAP
Pathogenic
0.89
D
MetaRNN
Benign
0.089
T
MetaSVM
Uncertain
0.38
D
MutationAssessor
Benign
1.8
L
PhyloP100
1.6
PrimateAI
Pathogenic
0.96
D
PROVEAN
Benign
-0.25
N
REVEL
Uncertain
0.30
Sift
Uncertain
0.022
D
Sift4G
Benign
0.16
T
Polyphen
0.20
B
Vest4
0.28
MutPred
0.29
Loss of helix (P = 0.0167)
MVP
0.81
MPC
1.1
ClinPred
0.11
T
GERP RS
1.8
Varity_R
0.19
gMVP
0.23
Mutation Taster
=78/22
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: rs772764704; hg19: chr15-73660218; API