SCN5A Variant p.R219HfsX11 Detail

We estimate the penetrance of LQTS for SCN5A p.R219HfsX11 around 4% and the Brugada syndrome penetrance around 19%. SCN5A p.R219HfsX11 was found in a total of 1 carriers in 0 papers and/or in gnomAD: 0 had Brugada syndrome, 0 had LQTS. p.R219HfsX11 is present in 1 alleles in gnomAD. p.R219HfsX11 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 p.R219HfsX11 around 4% (0/11) and the Brugada syndrome penetrance around 19% (2/11).

In Silico Data

PROVEAN PolyPhen-2 BLAST-PSSM REVEL Penetrance Density BrS (%) Penetrance Density LQT3 (%)
NA NA NA None 23 2
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: - 1 1 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.

p.R219HfsX11 has 63 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
154 14 P154L,
223 9 V223L,
856 10 V856L,
862 11
859 5
149 13
147 11
164 13 F164L,
209 13 N209T, N209S,
863 11
156 10 W156X, W156R,
864 14
158 11 K158T,
216 6 S216X, S216L,
851 15 p.F851CfsX19, c.2550_2551dupGT, F851L, c.2552_2553dupGT,
221 9
852 14
854 13 c.2559delT,
222 6 R222X, R222Q, R222L,
224 12 L224F,
213 12
155 15
857 11 G857D,
150 15
157 13 T157I,
882 15
160 14 p.V160fs,
881 14
226 15 A226G, A226V,
205 14 c.612-2A>G, Y205X,
860 10 p.L860fsx89,
206 11
214 12
858 10 M858L,
211 13
144 12
217 7
855 10
199 15 S199T,
148 9
165 13
884 15
210 12 I210T,
204 9 c.611+3_611+4dupAA, A204T, c.611+1G>A, A204V,
162 13 Y162C, Y162H,
203 10
208 11 E208K,
168 15
202 14 I202T,
152 13 D152N,
161 9 E161K, E161Q,
201 13
219 0 c.656_657insATTCA, R219H, p.R219HfsX11, R219C,
225 14 R225W, R225Q,
151 9
218 6
207 7
212 10 L212Q, L212P,
215 10 p.L215CfsX10,
200 11
145 14
861 13 p.F861WfsX90, c.2582_2583delTT,
220 6 T220I,