SCN5A Variant Q641H Detail

We estimate the penetrance of LQTS for SCN5A Q641H around 10% and the Brugada syndrome penetrance around 14%. SCN5A Q641H was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. Q641H is not present in gnomAD. Q641H has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Mild_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (1 diagnosed with Brugada syndrome) and 5 individuals for LQTS (0 with LQTS). These data combined with observations of carriers lead us to estimate the LQTS penetrance for SCN5A Q641H around 10% (0/10) and the Brugada syndrome penetrance around 14% (1/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.554 14 11
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 BrS/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 LQT3 BrS1 Other Other Disease
LITERATURE, COHORT, AND GNOMAD: - 0 0 0 0 -
VARIANT FEATURES ALONE: - 15 14 0 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.

Q641H 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. 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
626 15
627 14 P627L,
628 14 P628R,
629 13 D629Y,
630 13 T630M,
631 12 p.T631VfsX101, c.1890+5G>A, c.1890G>A,
632 11 T632M,
633 11
634 10 S634W, S634L,
635 9
636 8 E636K,
637 8 P637L,
638 7 G638D,
639 5 G639R, G639A,
640 4 P640A, P640L, P640S,
641 0
642 4
643 5
644 7
645 8
646 8 p.Q646RfsX5, c.1936delC,
647 9 A647V, A647D, A647S,
648 10 P648L,
649 11 C649Y, C649R,
650 11
651 12 c.1950_1953delAGAT, D651H,
652 13 G652D, G652S,
653 13
654 14 E654Q, E654D, E654X , E654K,
655 14 E655K,
656 15 P656L,