Submissions for variant NM_001267550.2(TTN):c.94816C>T (p.Arg31606Ter)

dbSNP: rs1060500435

Total submissions: 5

Submitter	RCV	SCV	Clinical significance	Condition	Last evaluated	Review status	Method	Comment
Invitae	RCV000475125	SCV000542459	likely pathogenic	Dilated cardiomyopathy 1G; Autosomal recessive limb-girdle muscular dystrophy type 2J	2023-10-12	criteria provided, single submitter	clinical testing	This sequence change creates a premature translational stop signal (p.Arg31606*) in the TTN gene. While this is not anticipated to result in nonsense mediated decay, it is expected to create a truncated TTN protein. This variant is not present in population databases (gnomAD no frequency). This premature translational stop signal has been observed in individual(s) with clinical features of TTN-related conditions (PMID: 27813223, 29447731, 31638414). ClinVar contains an entry for this variant (Variation ID: 404748). This variant is located in the A band of TTN (PMID: 25589632). Truncating variants in this region are significantly overrepresented in patients affected with dilated cardiomyopathy (PMID: 25589632). Truncating variants in this region have also been reported in individuals affected with autosomal recessive centronuclear myopathy (PMID: 23975875). In summary, the currently available evidence indicates that the variant is pathogenic, but additional data are needed to prove that conclusively. Therefore, this variant has been classified as Likely Pathogenic.
Ambry Genetics	RCV002365595	SCV002662392	likely pathogenic	Cardiovascular phenotype	2021-06-18	criteria provided, single submitter	clinical testing	The p.R22541* variant (also known as c.67621C>T), located in coding exon 168 of the TTN gene, results from a C to T substitution at nucleotide position 67621. This changes the amino acid from an arginine to a stop codon within coding exon 168. This exon is located in the A-band region of the N2-B isoform of the titin protein and is constitutively expressed in TTN transcripts (percent spliced in or PSI 100%). This alteration has been reported in association with dilated cardiomyopathy (DCM) (Jansweijer JA et al. Eur J Heart Fail, 2017 04;19:512-521; van Waning JI et al. J Am Coll Cardiol, 2018 02;71:711-722). This variant is considered to be rare based on population cohorts in the Genome Aggregation Database (gnomAD). This alteration is expected to result in loss of function by premature protein truncation or nonsense-mediated mRNA decay. While truncating variants in TTN are present in 1-3% of the general population, truncating variants in the A-band are the most common cause of dilated cardiomyopathy (DCM) (Herman DS et al. N. Engl. J. Med., 2012 Feb;366:619-28; Roberts AM et al. Sci Transl Med, 2015 Jan;7:270ra6). TTN truncating variants encoded in constitutive exons (PSI >90%) have been found to be significantly associated with DCM regardless of their position in titin (Schafer S et al. Nat. Genet., 2017 01;49:46-53). As such, this alteration is classified as likely pathogenic.
GeneDx	RCV001700373	SCV003845701	likely pathogenic	not provided	2022-09-21	criteria provided, single submitter	clinical testing	Identified in patients with DCM and early-onset atrial fibrillation in published literature (van Waning et al., 2018; Jansweijer et al., 2017, Goodyer et al., 2019); Not observed at significant frequency in large population cohorts (gnomAD); Nonsense variant predicted to result in protein truncation or nonsense mediated decay in a gene for which loss of function is a known mechanism of disease; Located in the A-band region of TTN in which the majority of loss of function variants have been associated with autosomal dominant titinopathies (Herman et al., 2012); This variant is associated with the following publications: (PMID: 22335739, 31638414, 27813223, Atak2021[Computational], 29447731)
Clinical Genetics, Academic Medical Center	RCV001700373	SCV001918346	likely pathogenic	not provided		no assertion criteria provided	clinical testing
Diagnostic Laboratory, Department of Genetics, University Medical Center Groningen	RCV001700373	SCV001963614	likely pathogenic	not provided		no assertion criteria provided	clinical testing