KCNH2 Variant R791L Detail

We estimate the penetrance of LQTS for KCNH2 R791L is 11%. We are unaware of any observations of this variant in individuals. R791L is not present in gnomAD. We have tested the trafficking efficiency of this variant, 70% of WT with a standard error of 11%; 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. R791L 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 R791L around 11% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-5.668 0.806 -2 0.834 9
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: - 0 0 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.

R791L has 48 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
791 0 R791W, R791Q,
819 5 N819K, N819K,
794 6 V794I, V794D,
792 6
820 6 G820R, G820R,
790 6
796 7 V796Del, V796L, V796L,
821 8 D821E, D821E,
789 8
795 9 V795I,
793 9 D793N,
772 9
36 9 V36X,
818 10 S818W, S818A, S818L,
797 10 A797T,
862 10 L862P,
61 10 Q61R,
860 10
863 11 R863P, R863X,
822 11 V822L, V822L, V822M,
37 11
35 11 R35W,
40 11
33 11 N33T,
823 12 R823fsX, R823W, R823Q, R823T,
773 12
788 12 E788D, E788D, E788K,
42 12 I42N,
771 12 H771fsX, H771R,
770 12
861 13 N861I, N861H,
774 13 D774X, D774Y,
38 13
34 13 A34T,
60 13 M60T,
41 13 V41A,
817 14
39 14 C39R, C39X,
798 14 I798fsX,
748 14
806 14 G806R, G806R,
32 14 A32T,
12 15 N12D,
747 15
799 15 L799sp,
805 15 F805S, F805C,
768 15
787 15