KCNH2 Variant R784Q Detail

We estimate the penetrance of LQTS for KCNH2 R784Q is 5%. This variant was found in a total of 15 carriers in 0 papers or gnomAD, 0 had LQTS. R784Q is present in 15 alleles in gnomAD. R784Q has not been functionally characterized. This residue is located in a Mild_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 R784Q around 5% (1/25).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.857 1.0 1 0.887 15
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: - 15 15 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.

R784Q has 46 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
784 0 R784Q, R784G, R784W,
783 4 S783P,
829 4 D829E, D829E, D829A,
785 6 G785S, G785D, G785fsX,
801 7 K801T,
828 7
782 8 I782fsX, I782N,
830 9
735 9 S735L,
826 9 T826I, T826A,
800 9
762 9
802 10
786 10
827 10
831 10
763 11
734 11 R734C, R734H,
736 11
803 12 D803X, D803Y,
787 12
761 12
760 12
739 12 H739fsX,
20 12 R20G, R20L,
479 12
707 12
781 13
733 13
764 13
799 13 L799sp,
732 13
825 13
824 13
16 13 D16A,
688 13
687 14
765 14
740 14 C740G, C740W,
686 14
731 14 H731R,
738 14 Q738X,
703 15
19 15 I19F,
804 15
478 15 A478D,