KCNH2 Variant D197N Detail

We estimate the penetrance of LQTS for KCNH2 D197N is 5%. This variant was found in a total of 7 carriers in 0 papers or gnomAD (version 4), 0 had LQTS. D197N is present in 7 alleles in gnomAD. We have tested the trafficking efficiency of this variant, 90% of WT with a standard error of 20%; 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. D197N 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 0 individuals with LQT2 and 10 unaffected individuals.These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 D197N around 5% (0/17).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-1.155 0.048 0 0.381 31
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: - 7 2 0 -
VARIANT FEATURES ALONE: - 10 10 0 -
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.

D197N has 31 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
197 0 D197N, D197Y,
196 4
198 4 V198L, V198L,
195 5
199 5
194 7 V194M,
200 7 L200Q,
193 8 A193T, A193X, A193V, A193fsX,
201 8
192 8 G192fsX,
202 8
191 9 P191fsX, P191Q,
203 9 A203T,
190 10 A190V, A190T,
204 10
189 11 G189Ins,
205 11 P205L,
188 11 A188P, A188X, A188S,
206 11
187 12 G187A, G187S, G187Del, G187X,
207 12 S207X,
186 13 G186fsX,
208 13 E208X,
185 13
209 13
184 14 G184Del,
210 14
183 14 G183fsX,
211 14
182 15 S182X,
212 15