KCNQ1 Variant R519H Detail

We estimate the penetrance of LQTS for KCNQ1 R519H is 3%. This variant was found in a total of 149 carriers in 6 papers or gnomAD, 2 had LQTS. R519H is present in 7 alleles in gnomAD. R519H has been functionally characterized in 1 papers. This residue is located in a Mild_Hotspot region for LQT1. In silico predictions, functional data (if available), and location in structure are equivalent to observing 2 individuals with LQT1 and 8 unaffected individuals. These data combined with observations of carriers lead us to estimate the LQTS penetrance for KCNQ1 R519H around 3% (4/159).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density (%)
-3.71 1.0 -2 0.876 13
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 LQT1 Other Disease
32893267 2020 1 None 1 None
30758498 2019 1 None None None
26496715 2016 1 None 1 None
22949429 2012 1 1 None None
19841300 2009 1 1 None None
17016049 2007 139 139 None atrial fibrillation
LITERATURE, COHORT, AND GNOMAD: - 149 147 2
VARIANT FEATURES ALONE: - 10 8 2 -
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

Peak current is relative to wildtype (100% being no different from wildtype). V0.5 activation is the voltages at which half of the maximal current is reached during an activation 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 Peak Current IKs (%WT) V1/2 Act. Activation time (%WT) Deactivation time (%WT)
34930020 HEK 16 2.02 1.71 0.98

Functional Data Heterozygously Collected

Functional parameters are the same as defined above.

PubMed ID Cell Type Peak Current IKs (%WT) V1/2 Act. Activation time (%WT) Deactivation time (%WT)
34930020 HEK 51 1.26 1.82 0.96

R519H 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. This results from the fact that the functional KV7.1 channel 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
519 0 R519H, R519C,
516 5
523 6
515 6
520 6 M520R,
381 7 C381Y,
522 7 Y522S,
517 8 I517T,
518 8 R518Q, R518G,
521 8
377 10
384 10
378 10 A378T,
514 10 I514T,
512 10
524 11 V524G,
513 11 T513A, T513S, T513S,
380 11 R380S, R380S, R380G,
385 11 E385K,
526 11 K526Q, K526E,
525 12 A525T, A525V,
383 12
374 13 L374H, L374F,
382 13
392 14 W392R, W392R, W392ins,
379 14 W379R, W379R, W379C, W379C, W379G,
527 14
373 14 S373P,
511 14 R511Q, R511W,
376 15
375 15