KCNH2 Variant R694H Detail

We estimate the penetrance of LQTS for KCNH2 R694H is 8%. This variant was found in a total of 4 carriers in 1 papers or gnomAD (version 4), 0 had LQTS. R694H is present in 3 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 57% of WT with a standard error of 7%; 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. R694H 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 1 individuals with LQT2 and 9 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R694H around 8% (1/14).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-4.862 1.0 0 0.923 2
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
23207121 2012 1 1
LITERATURE, COHORT, AND GNOMAD: - 4 2 0 -
VARIANT FEATURES ALONE: - 10 9 1 -
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.

R694H has 39 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
694 0 R694H, R694C,
698 5 E698K, E698X,
691 6
689 6
684 6
695 6
690 6
693 6 L693X,
697 7 L697X,
692 7
681 9 R681W,
680 9
696 9 R696H, R696C,
5 9
685 10 R685H, R685C, R685P,
699 10 E699D, E699D,
683 10
688 10
677 11 M677T,
687 11
731 11 H731R,
728 11
701 12
727 12
702 12
403 12
3 12
724 12 L724X,
682 13 E682X,
6 13 G6R,
700 13
7 13
544 13 E544A, E544fsX,
720 13
686 13
678 13
4 14
732 14
716 14 V716G,