KCNH2 Variant V612L Detail

We estimate the penetrance of LQTS for KCNH2 V612L is 37%. This variant was found in a total of 4 carriers in 1 papers or gnomAD (version 4), 2 had LQTS. V612L is present in 1 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 0% of WT with a standard error of 19%; 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. V612L has been functionally characterized in 2 papers. 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 V612L around 37% (5/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.595 0.338 1 0.76 86
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
9544837 1998 3 1 2
LITERATURE, COHORT, AND GNOMAD: - 4 1 2 -
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.

Functional Data Homozygously Collected

Steady state (S.S.) and peak tail current are relative % to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype. Recovery from inactivation (Rec. inact.) and deactivation time (Deactivation) are the ratio of characteristic time constants with wildtype (unitless).

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Recov. Inact. Deactivation (%WT)
11524404 Xeno 0 None None None None
15851652 HEK293 None None None None

Functional Data Heterozygously Collected

Functional parameters are the same as defined above.

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Deactivation (%WT)
11524404 Xeno 68 25 1.1 -1.3 None
15851652 HEK293 None None None

V612L has 64 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
612 0 V612L, V612A, V612L,
613 4 T613A, T613K, T613M, T613L,
611 5 Y611D,
609 5 D609N, D609G,
615 5 L615F, L615V,
614 6 A614T, A614V,
638 6 K638D, K638E, K638R, K638Del,
635 6 N635I,
608 6
639 7 I639N, I639F,
616 7 Y616S,
610 8
642 8 I642V, I642Del,
565 9
607 9
636 9
634 9 T634S, T634P, T634I, T634S, T634A,
606 9 S606F, S606P, S606Del,
641 10 S641F, S641P,
617 10 F617V, F617L, F617L, F617L,
632 10 P632S, P632A,
618 10 T618S, T618S,
619 10
562 10 H562Q, H562Q, H562P, H562R,
637 10 E637K, E637G, E637X,
589 11 L589P,
633 11 N633I, N633D, N633S,
569 11 Y569H, Y569C, Y569X,
566 11 C566S, C566R, C566F, C566G, C566S,
431 11 F431L, F431L, F431L,
630 11 V630I, V630A, V630T,
427 11 Y427H, Y427S, Y427C,
561 11 A561P, A561T, A561V,
568 11 W568C, W568C,
585 11 W585C, W585C,
605 12 P605L,
593 12 I593R, I593X, I593K, I593T, I593V,
629 12 N629S, N629T, N629D, N629K, N629I, N629K,
620 12 S620I, S620G,
640 12 F640V, F640L, F640L, F640Del, F640L,
645 12 M645V, M645L, M645I, M645I, M645R, M645L, M645I,
586 12 L586M,
643 12
564 13 L564L,
627 13 F627L, F627L, F627X, F627L, F627fsX,
558 13 A558E, A558P, A558V,
592 13 Q592X,
631 14 S631F,
423 14
430 14
567 14 I567M, I567T,
595 14 K595N, K595E, K595N,
646 14
644 14 V644I, V644F,
590 14 G590D, G590V,
621 14 S621R, S621R, S621N, S621R,
628 14 G628R, G628A, G628S, G628Del, G628D, G628V,
631 15 S631F,
588 15 N588D, N588K, N588K,
426 15 P426H,
570 15
559 15 L559H, L559F,
571 15 I571V, I571L,
604 15 G604C, G604S, G604D,