KCNH2 Variant D609N Detail

We estimate the penetrance of LQTS for KCNH2 D609N is 60%. This variant was found in a total of 11 carriers in 4 papers or gnomAD (version 4), 10 had LQTS. D609N is not present in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 0%; in our analysis we used SE < 20% as 'high quality'. Approximately below 50% of WT is considered PS3 moderate and below 30% is PS3 strong. D609N has not been functionally characterized. This residue is located in a Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 3 individuals with LQT2 and 7 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 D609N around 60% (13/21).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.342 0.786 1 0.8 90
PROVEAN scores less than -2 are considered deleterious. REVEL scores higher than 0.5 or 0.75 are considered likely pathogenic (higher sensitivity with the former cutoff, higher specificity with the latter cutoff). A PolyPhen-2 score of 0.85 or greater is considered likely pathogenic. BLAST-PSSM reflects the evolutionary conservation of residue substitutions, more negative numbers indicate fewer observations of the specific substitution than is expected. Penetrance density is our previously published method to calculate the average LQTS probability density in a shell of residues surrounding a residue of interest (Kroncke et al. 2019).

Reported Carrier Data

PubMed ID Year Carriers Unaffected LQT2 Other Disease
11854117 2002 5 0 5
France Cohort 2020 5 1 4
10973849 2000 1 0 1
18808722 2008 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 11 1 10 -
VARIANT FEATURES ALONE: - 10 7 3 -
Summary totals might not agree with the literature table because of duplicate patients, which were excluded from the total counts. We do not distinguish here between multiple missense codons. Missense variants are combined across degenerate codon substitutions since codon-level data were not consistently available for curation.

D609N has 57 previously observed neighbors within 15 angstroms

A residue within a folded protein on average has nearest neighbors that fall roughly into two shells: a "nearest" neighbor around 5-6 angstroms and a second shell around 11 angstroms. NOTE: some residues appear multiple times at different distances since the functional KV11.1 channel (protein product of KCNH2/hERG) is a homotetramer and occasionally the same residue from multiple subunits is present within the 15A window. All variants shown in the rightmost column have been observed in at least one individual in the literature or gnomAD.

Neighbor Distance (Angstroms) Variants Observed in Individuals
609 0 D609G, D609N,
610 5
606 5 S606F, S606Del, S606P,
608 5
612 5 V612L, V612L, V612A,
635 6 N635I,
613 6 T613K, T613A, T613L, T613M,
607 6
611 7 Y611D,
605 7 P605L,
638 8 K638R, K638E, K638D, K638Del,
614 8 A614T, A614V,
589 8 L589P,
593 9 I593K, I593R, I593V, I593T, I593X,
634 9 T634S, T634P, T634S, T634I, T634A,
595 10 K595N, K595N, K595E,
615 10 L615V, L615F,
586 10 L586M,
569 10 Y569X, Y569H, Y569C,
431 10 F431L, F431L, F431L,
639 10 I639F, I639N,
616 10 Y616S,
604 10 G604C, G604S, G604D,
636 10
633 10 N633I, N633S, N633D,
585 11 W585C, W585C,
590 11 G590D, G590V,
592 11 Q592X,
565 12
594 12
427 12 Y427S, Y427H, Y427C,
637 12 E637G, E637X, E637K,
632 12 P632A, P632S,
630 12 V630I, V630A, V630T,
568 13 W568C, W568C,
566 13 C566S, C566R, C566G, C566F, C566S,
617 13 F617L, F617L, F617V, F617L,
629 13 N629S, N629K, N629K, N629D, N629I, N629T,
642 13 I642Del, I642V,
588 13 N588K, N588D, N588K,
603 13 G603D,
562 14 H562P, H562Q, H562R, H562Q,
573 14
597 14 Y597C, Y597H,
430 14
641 14 S641P, S641F,
596 14 P596L, P596S, P596T, P596R,
591 14 D591H, D591N,
583 14 I583V,
572 14 G572C, G572D, G572R, G572S,
618 14 T618S, T618S,
587 14
584 15 G584C, G584S, G584R,
570 15
432 15
575 15 E575K,
619 15