SCN5A Variant W904R Detail

We estimate the penetrance of LQTS for SCN5A W904R around 6% and the Brugada syndrome penetrance around 29%. SCN5A W904R was found in a total of 0 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. W904R is not present in gnomAD. W904R has been functionally characterized in 0 papers. This residue is located in a Mild_Hotspot region for Brugada syndrome and a Non_Hotspot region for LQTS. In silico predictions, functional data (if available), and location in structure are equivalent to phenotyping 10 individuals for Brugada syndrome (2 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 W904R around 6% (0/10) and the Brugada syndrome penetrance around 29% (2/10).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA 0.925 38 3
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 13 0 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.

W904R has 65 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
364 10
890 14 I890T,
901 7 E901K, S901L,
919 10
276 14 L276P, L276Q,
363 8
348 10 P348A,
360 9
894 13 I894M,
355 14 F355I, F355C,
372 11
356 15 D356N,
361 13
904 0 W904X,
366 13
365 14
376 11 R376H, R376C,
871 13
354 11
897 14 G897E, G897R,
909 11
902 7
349 7 D349N,
373 11
881 15
357 14
898 12
893 13 R893H, R893C,
362 14
911 11 G911E,
920 12
900 5
872 14 D872N,
918 13
917 13 L917V, L917R,
865 14
913 12
916 9
912 9 Q912R,
347 10
906 8
351 8 G351D, G351C, G351V, G351S,
910 12 S910L,
350 5 H350Q,
903 5 p.M903CfsX29,
367 9 R367H, R367C, R367L,
346 13 E346G, E346D, E346X, E346K,
359 12 A359T, p.A359PfsX12,
370 14 T370M,
877 14
879 14 W879R,
923 14
905 6
375 15
352 6 Y352C,
915 9 C915R,
368 14
899 9
380 14
377 12
908 8
914 14
861 14 c.2582_2583delTT, p.F861WfsX90,
353 8 T353I,
907 6