KCNH2 Variant V644F Detail

We estimate the penetrance of LQTS for KCNH2 V644F is 27%. This variant was found in a total of 9 carriers in 2 papers or gnomAD (version 4), 9 had LQTS. V644F is not present in gnomAD. We have tested the trafficking efficiency of this variant, 15% of WT with a standard error of 9%; 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. V644F 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 2 individuals with LQT2 and 8 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 V644F around 27% (11/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.758 0.903 -1 0.931 68
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
Japan Cohort 2020 6 0 6
Italy Cohort 2020 3 0 3
LITERATURE, COHORT, AND GNOMAD: - 9 0 9 -
VARIANT FEATURES ALONE: - 10 8 2 -
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.

V644F has 74 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
644 0 V644I, V644F,
643 4
645 5 M645V, M645L, M645I, M645I, M645R, M645L, M645I,
641 5 S641F, S641P,
647 5
621 5 S621R, S621R, S621N, S621R,
640 6 F640V, F640L, F640L, F640Del, F640L,
622 6 L622F,
648 6 G648A,
642 6 I642V, I642Del,
646 7
618 7 T618S, T618S,
564 7 L564L,
649 8
617 8 F617V, F617L, F617L, F617L,
620 9 S620I, S620G,
561 9 A561P, A561T, A561V,
639 9 I639N, I639F,
560 10 I560fsX, I560M,
619 10
568 10 W568C, W568C,
623 10 T623I,
651 10 M651K,
623 10 T623I,
625 10 V625E,
567 10 I567M, I567T,
619 10
650 10 L650X,
624 10 S624R, S624N, S624R, S624R,
627 11 F627L, F627L, F627X, F627L, F627fsX,
565 11
616 11 Y616S,
620 11 S620I, S620G,
638 11 K638D, K638E, K638R, K638Del,
632 11 P632S, P632A,
637 11 E637K, E637G, E637X,
557 12
652 12 Y652X,
614 12 A614T, A614V,
626 12 G626A, G626V, G626S,
625 12 V625E,
615 12 L615F, L615V,
624 12 S624R, S624N, S624R, S624R,
636 12
563 12 W563C, W563X, W563G, W563C,
626 13 G626A, G626V, G626S,
615 13 L615F, L615V,
571 13 I571V, I571L,
631 13 S631F,
557 13
566 13 C566S, C566R, C566F, C566G, C566S,
630 13 V630I, V630A, V630T,
554 13
622 13 L622F,
558 13 A558E, A558P, A558V,
616 14 Y616S,
562 14 H562Q, H562Q, H562P, H562R,
653 14
652 14 Y652X,
645 14 M645V, M645L, M645I, M645I, M645R, M645L, M645I,
618 14 T618S, T618S,
558 14 A558E, A558P, A558V,
559 14 L559H, L559F,
621 14 S621R, S621R, S621N, S621R,
612 14 V612L, V612A, V612L,
656 14 F656L, F656L, F656L,
655 15
585 15 W585C, W585C,
570 15
627 15 F627L, F627L, F627X, F627L, F627fsX,
634 15 T634S, T634P, T634I, T634S, T634A,
654 15
556 15
617 15 F617V, F617L, F617L, F617L,