KCNH2 Variant R665Q Detail

We estimate the penetrance of LQTS for KCNH2 R665Q is 8%. This variant was found in a total of 3 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. R665Q is present in 3 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 124% of WT with a standard error of 15%; 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. R665Q has not been functionally characterized. This residue is located in a Non_Hotspot region for LQT2. In silico predictions, functional data (if available), and location in structure are equivalent to observing 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R665Q around 8% (0/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.874 0.97 1 0.821 4
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: - 3 1 0 -
VARIANT FEATURES ALONE: - 10 10 0 -
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.

R665Q has 51 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
665 0 R665Q,
662 5
666 6
661 6 A661V,
675 7
546 7
674 7 H674fsX, H674Y,
678 7
668 7 S668L,
664 7 Q664X,
663 8
671 9 A671Del, A671G,
549 9 V549M,
667 9 Y667X,
658 9
547 10 A547T,
659 10
660 10 S660L,
543 10 S543fsX,
550 11
669 11 G669X, G669R, G669C,
677 11 M677T,
679 11 R679W, R679Q,
548 11
673 11
676 11 Q676X, Q676fsX,
682 11 E682X,
670 11
657 11 G657S, G657V,
681 12 R681W,
671 12 A671Del, A671G,
545 12
672 12 R672C, R672H,
544 12 E544A, E544fsX,
664 12 Q664X,
672 12 R672C, R672H,
670 12
553 13 L553V,
669 13 G669X, G669R, G669C,
668 14 S668L,
680 14
654 14
710 14
552 14 L552S,
655 14
709 15
540 15 D540fsX,
711 15 I711V,
656 15 F656L, F656L, F656L,
658 15
667 15 Y667X,