SCN5A Variant V845A Detail

We estimate the penetrance of LQTS for SCN5A V845A around 12% and the Brugada syndrome penetrance around 53%. SCN5A V845A was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. V845A is not present in gnomAD. V845A 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 (5 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 V845A around 12% (0/10) and the Brugada syndrome penetrance around 53% (5/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.954 80 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 10 0 5 - -
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.

V845A has 68 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
891 14 I891T, I891N,
888 14
848 5 I848F,
223 14 V223L,
937 13
895 12 L895F,
839 10 L839P,
842 6
247 15 V247L,
240 8 V240M,
231 10 c.692_693delCA,
1455 13
193 13 W193R, W193X,
926 10
237 12
228 12 K228R,
138 15 M138I,
925 11 I925F,
227 9 L227P,
836 14 V836M,
234 11 P234S,
142 14
934 11
933 10
229 9
246 14
851 11 c.2552_2553dupGT, F851L, c.2550_2551dupGT, p.F851CfsX19,
412 15 V412D,
924 15 V924I,
927 14 N927S, N927K,
852 10
854 14 c.2559delT,
224 14 L224F,
845 0 c.2533delG,
232 11 V232F, V232I,
244 13
892 14 F892I,
849 6
226 10 A226G, A226V,
922 13 V922I,
241 11
235 11 G235R, c.704-1G>C, c.703+1G>A,
840 8
843 6 T843A,
930 8 c.2788-6C>T, c.2787+17_2787+18insACACACACACACACACACACACA,
1459 13 c.4376_4379delTCTT,
837 12
239 7 I239V, I239V ,
230 6 I230M, I230T, I230V,
242 11 A242D,
929 11
416 13 Y416C,
841 7 p.N841TfsX2, N841K,
236 9
847 6
846 5 L846R,
936 15
238 11
233 8
838 11
853 12
844 5 L844RfsX3,
850 9 c.2549_2550insTG, V850M,
243 9
932 14
835 15 S835A, S835L,
145 14
931 11