SCN5A Variant A819P Detail

We estimate the penetrance of LQTS for SCN5A A819P around 12% and the Brugada syndrome penetrance around 33%. SCN5A A819P was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. A819P is not present in gnomAD. A819P has been functionally characterized in 0 papers. This residue is located in a 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 (3 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 A819P around 12% (0/10) and the Brugada syndrome penetrance around 33% (3/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.979 44 12
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 12 0 3 - -
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.

A819P has 47 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
723 13 I723V,
821 5
1340 10 V1340I,
1339 11 p.L1339del, L1339F,
780 12
721 15
812 13 L812Q,
1344 10 F1344S, F1344L,
731 13 T731I,
819 0
826 5 N826D,
818 5
825 4
781 7 W781X,
720 13
822 6 W822C, W822X,
830 11
788 14 I788V,
1346 14 L1346I, L1346P,
833 13 G833R,
724 10 T724I,
782 14 N782T,
1341 14
831 13
728 13 V728I,
820 5
823 7 P823T,
727 11
827 9
814 13 R814Q,
816 7 F816Y, F816L,
813 12 c.2437-5C>A, c.2436+12G>A,
817 6 K817E,
779 14 Q779X, Q779K,
815 8
1343 9
1337 15
1342 14
784 10 F784L,
785 12 D785N,
783 15 I783T,
1347 12
1336 14
824 8
829 7
832 12
828 9 L828V,