KCNH2 Variant H70R Detail

We estimate the penetrance of LQTS for KCNH2 H70R is 73%. This variant was found in a total of 3 carriers in 4 papers or gnomAD, 3 had LQTS. H70R is not present in gnomAD. H70R has been functionally characterized in 2 papers. 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 H70R around 73% (9/13).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-2.523 0.989 -1 0.822 70
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
11854117 2002 1 0 1
10973849 2000 2 0 2
15840476 2005 1 0 1
22885918 2012 1 0 1
LITERATURE, COHORT, AND GNOMAD: - 3 0 3 -
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.

Functional Data Homozygously Collected

Steady state (S.S.) and peak tail current are relative % to wildtype (100% being no different from wildtype). V0.5 act/inact are the voltages at which half of the maximal current is reached during an activation and inactivation protocol, each is in units of mV and relative to wildtype. Recovery from inactivation (Rec. inact.) and deactivation time (Deactivation) are the ratio of characteristic time constants with wildtype (unitless).

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Recov. Inact. Deactivation (%WT)
10187793 Xeno -1.6 9.5 None None
21536673 Xeno 50 None None None None

Functional Data Heterozygously Collected

Functional parameters are the same as defined above.

PubMed ID Cell Type S.S Peak (%WT) Peak Tail IKr (%WT) V1/2 Act. V1/2 Inact. Deactivation (%WT)
10187793 Xeno None None None
21536673 Xeno None None None

H70R has 47 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
70 0 H70Q, H70R, H70Q,
69 5 L69Del, L69P,
71 5 G71R, G71W, G71R, G71E,
67 5
74 6 T74fsX, T74M,
98 6
66 6 C66R, C66G, C66Y,
68 7 F68L, F68L, F68V, F68L,
99 7 Y99N, Y99S,
79 8 A79T, A79Del, A79fsX, A79S,
97 8
96 8 I96T, I96V,
65 8 T65P,
72 8 P72R, P72Q, P72T, P72S,
73 9 R73fsX, R73G, R73C, R73H,
75 9 Q75X,
76 10
78 10 A78P, A78T,
82 10 I82Del, I82Ins, I82dup, I82T,
106 11 F106L, F106L, F106V, F106L,
105 11
80 11 A80P,
63 11 P63H,
64 11 C64Y, C64R,
77 12 R77S,
100 12 R100Q, R100G, R100P,
108 12 C108Y,
52 12 C52W,
54 12 Y54N, Y54X,
110 12 V110A,
83 12 A83P, A83fsX,
103 12
62 13 R62Q,
94 13 V94L, V94L, V94A,
81 13 Q81H, Q81P, Q81X, Q81E, Q81H,
107 13 L107P,
104 13
95 13 E95G, E95K,
101 13 K101E,
129 13 F129C,
59 14
51 14
48 14
127 14
102 15 D102V, D102H, D102X,
109 15 L109X, L109Q, L109P,
53 15 G53S, G53R,