KCNH2 Variant A614V Detail

We estimate the penetrance of LQTS for KCNH2 A614V is 95%. This variant was found in a total of 50 carriers in 18 papers or gnomAD, 49 had LQTS. A614V is not present in gnomAD. A614V has been functionally characterized in 4 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 7 individuals with LQT2 and 3 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 A614V around 95% (56/60).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.792 1.0 0 0.961 87
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
19843919 2009 1 1
Japan Cohort 2020 11 1 10
14642690 1 0 1
Italy Cohort 2020 2 0 2
11854117 2002 3 0 3
23864605 2013 25 0
9544837 1998 4 0 4
9693036 1998 10 0 10
15090700 2004 2 0 2
15840476 2005 2 0 2
19070294 2008 9 0 9
18808722 2008 1 0 1
19996378 2009 1 0 1
24218437 2013 1 0 congenital LQT
26496715 2015 9 0 9
27555138 2016 1 0 1
None 0 1
Personal Communication 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 50 1 49 -
VARIANT FEATURES ALONE: - 10 3 7 -
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)
9721698 Xeno 0 None None None None
16432067 HEK293 10 None None None None
21240260 hiPSC-CM None None None None
23864605 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)
9721698 Xeno 18 36 3.1 -9.3 1.0
16432067 HEK293 None None None
21240260 hiPSC-CM 33 None None None
23864605 HEK293 None None None

A614V has 80 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
614 0 A614V, A614T,
613 4 T613K, T613L, T613M, T613A,
615 4 L615F, L615V,
565 5
612 6 V612L, V612A, V612L,
617 6 F617L, F617V, F617L, F617L,
611 6 Y611D,
568 6 W568C, W568C,
618 6 T618S, T618S,
616 7 Y616S,
566 8 C566S, C566G, C566R, C566F, C566S,
585 8 W585C, W585C,
610 8
569 8 Y569C, Y569H, Y569X,
609 8 D609N, D609G,
630 8 V630A, V630I, V630T,
564 8 L564L,
561 9 A561V, A561T, A561P,
638 9 K638D, K638Del, K638R, K638E,
619 9
562 9 H562Q, H562Q, H562R, H562P,
567 9 I567M, I567T,
620 10 S620G, S620I,
642 10 I642Del, I642V,
586 10 L586M,
431 10 F431L, F431L, F431L,
589 10 L589P,
570 10
621 11 S621R, S621R, S621N, S621R,
640 11 F640L, F640L, F640Del, F640V, F640L,
571 11 I571V, I571L,
607 11
631 11 S631F,
608 11
635 11 N635I,
639 11 I639N, I639F,
572 11 G572D, G572S, G572R, G572C,
629 11 N629I, N629S, N629D, N629K, N629T, N629K,
637 12 E637K, E637G, E637X,
427 12 Y427S, Y427H, Y427C,
622 12 L622F,
641 12 S641F, S641P,
430 12
632 12 P632S, P632A,
606 12 S606P, S606Del, S606F,
644 12 V644I, V644F,
632 12 P632S, P632A,
627 12 F627X, F627L, F627L, F627L, F627fsX,
558 12 A558E, A558P, A558V,
563 12 W563C, W563G, W563X, W563C,
641 12 S641F, S641P,
573 12
645 12 M645R, M645L, M645I, M645I, M645I, M645V, M645L,
628 13 G628V, G628A, G628R, G628D, G628Del, G628S,
560 13 I560fsX, I560M,
605 13 P605L,
588 13 N588D, N588K, N588K,
633 13 N633I, N633D, N633S,
426 13 P426H,
626 13 G626S, G626V, G626A,
634 13 T634S, T634P, T634I, T634S, T634A,
592 13 Q592X,
584 13 G584S, G584R, G584C,
559 14 L559F, L559H,
623 14 T623I,
627 14 F627X, F627L, F627L, F627L, F627fsX,
593 14 I593X, I593T, I593K, I593R, I593V,
625 14 V625E,
423 14
636 14
637 14 E637K, E637G, E637X,
557 14
590 14 G590D, G590V,
636 15
631 15 S631F,
633 15 N633I, N633D, N633S,
587 15
429 15 A429V, A429P,
646 15
643 15