KCNH2 Variant E699D Detail

We estimate the penetrance of LQTS for KCNH2 E699D is 10%. This variant was found in a total of 2 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. E699D is present in 2 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 80% of WT with a standard error of 29%; 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. E699D 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 E699D around 10% (1/12).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.883 0.34 1 0.678 7
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: - 2 4 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.

E699D has 63 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
699 0 E699D, E699D,
698 6 E698K, E698X,
695 6
6 6 G6R,
700 6
696 7 R696H, R696C,
7 7
702 7
697 7 L697X,
5 7
703 7
764 8
4 8
765 8
701 9
767 9 D767X,
766 9
481 9
704 10 A704V, A704T,
694 10 R694H, R694C,
693 10 L693X,
8 10
724 10 L724X,
692 11
827 11
763 11
720 11
706 11 S706C, S706F,
3 12
482 12 V482A,
476 12 V476I,
691 12
677 12 M677T,
680 12
478 12 A478D,
480 12 E480V,
721 12 P721L,
9 13 A9T, A9V,
403 13
768 13
705 13 W705X, W705fsX,
824 13
762 13
727 13
10 13
723 13 C723X, C723R, C723G,
673 14
689 14
402 14 H402R,
690 14
719 14
479 14
707 14
681 14 R681W,
684 14
826 14 T826I, T826A,
477 14
728 14
828 15
825 15
823 15 R823fsX, R823W, R823Q, R823T,
708 15
769 15