KCNH2 Variant L646V Detail

We estimate the penetrance of LQTS for KCNH2 L646V is 63%. We are unaware of any observations of this variant in individuals. L646V is not present in gnomAD. L646V 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 6 individuals with LQT2 and 4 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 L646V around 63% (6/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.784 0.41 1 0.858 74
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
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 -
VARIANT FEATURES ALONE: - 10 4 6 -
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.

L646V 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
646 0
647 5
649 5
643 6
645 6 M645I, M645R, M645L, M645V, M645I, M645I, M645L,
648 6 G648A,
642 7 I642Del, I642V,
644 7 V644F, V644I,
650 7 L650X,
554 7
619 7
557 7
623 8 T623I,
558 8 A558E, A558V, A558P,
641 9 S641P, S641F,
656 10 F656L, F656L, F656L,
651 10 M651K,
622 10 L622F,
622 10 L622F,
621 10 S621N, S621R, S621R, S621R,
640 11 F640L, F640V, F640L, F640Del, F640L,
652 11 Y652X,
555 11
561 11 A561P, A561V, A561T,
615 11 L615F, L615V,
639 11 I639F, I639N,
620 11 S620I, S620G,
556 11
653 12
618 12 T618S, T618S,
655 12
550 12
553 12 L553V,
625 12 V625E,
652 12 Y652X,
560 12 I560M, I560fsX,
616 12 Y616S,
659 12
559 12 L559F, L559H,
624 12 S624R, S624R, S624N, S624R,
624 12 S624R, S624R, S624N, S624R,
551 13 F551L, F551L, F551L,
564 13 L564L,
654 13
621 13 S621N, S621R, S621R, S621R,
623 13 T623I,
618 13 T618S, T618S,
560 13 I560M, I560fsX,
651 13 M651K,
562 14 H562P, H562R, H562Q, H562Q,
638 14 K638E, K638D, K638R, K638Del,
627 14 F627X, F627L, F627L, F627L, F627fsX,
648 14 G648A,
612 14 V612L, V612L, V612A,
552 14 L552S,
620 14 S620I, S620G,
655 15
617 15 F617L, F617V, F617L, F617L,
561 15 A561P, A561V, A561T,
617 15 F617L, F617V, F617L, F617L,
660 15 S660L,
626 15 G626V, G626S, G626A,
557 15
614 15 A614T, A614V,