SCN5A Variant Y1445H Detail

We estimate the penetrance of LQTS for SCN5A Y1445H around 1% and the Brugada syndrome penetrance around 9%. SCN5A Y1445H was found in a total of 9 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. Y1445H is present in 9 alleles in gnomAD. Y1445H 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 (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 Y1445H around 1% (0/19) and the Brugada syndrome penetrance around 9% (1/19).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
-4.72 0.961 -0.4 0.94 14 1
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: - 9 9 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.

Y1445H has 38 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
888 13
1355 11
1430 12 D1430N,
1352 14
1426 14
1445 0 Y1445H,
1447 7
1444 6 L1444I,
1351 14 M1351R, M1351V,
1440 14 W1440X,
1449 11 Y1449S, Y1449C,
1452 13
1429 8
1442 10 Y1442N, Y1442C,
806 13 V806M,
1450 12
1451 12 V1451D, V1451L,
886 12 H886Q, H886P,
1433 13 G1433W, G1433V, G1433R,
1431 11 S1431C,
805 13 S805L,
1359 14 K1359N, K1359M,
1356 12 c.4066_4068delTT,
889 13
1425 12
1427 14 A1427E, A1427S,
1446 4
1432 11 R1432G, R1432S,
1448 8 I1448L, I1448T,
1439 14 Q1439R, Q1439H,
884 13
885 9
1443 5 N1443S,
1441 12 E1441Q,
152 15 D152N,
883 13
1428 11 A1428S, A1428V,
804 14