Heart conduction disease
diseaseOn this page
Also known as cardiac conduction diseasecardiac conduction disorderconduction disease of heartdisease of cardiac conductiondisorder of cardiac conduction
Summary
Heart conduction disease (MONDO:0000992) is a disease (an umbrella term covering 10 Mondo subtypes) caused by variants in EMD and TTR, with 10 cohort genes (20 GWAS associations across 14 studies). The dominant Reactome pathway is Muscle contraction (3 cohort genes).
At a glance
- Causal genes: EMD (GenCC Strong), TTR (GenCC Strong)
- Umbrella term: 10 Mondo subtypes
- Cohort genes: 10
- GWAS associations: 20
Clinical features
No curated clinical features (Orphanet) for this disease.
Identifiers
Disease identifiers
| Field | Value |
|---|---|
| Canonical name | heart conduction disease |
| Mondo ID | MONDO:0000992 |
| DOID | DOID:10273 |
| SNOMED CT | 44808001 |
| Is cancer (heuristic) | no |
Also known as: cardiac conduction disease · cardiac conduction disorder · conduction disease of heart · disease of cardiac conduction · disorder of cardiac conduction
Data availability: 20 GWAS associations (14 studies) · 10 GenCC gene-disease records.
Disease family
An umbrella term covering 10 Mondo subtypes.
Classification path: disease › human disease › disease by body system or component › cardiovascular disorder › heart disorder › heart conduction disease
Related subtypes (33): endocardium disorder, pericardium disorder, cardiac tuberculosis, hypertensive heart disease, heart valve disorder, cardiomyopathy, coronary artery disorder, heart failure, congenital heart disease, heart aneurysm, rheumatic heart disease, cardiac rhythm disease, white forelock with malformations, atrioventricular defect-blepharophimosis-radial and anal defect syndrome, microcephaly-cardiac defect-lung malsegmentation syndrome, PHACE syndrome, microcephaly-facio-cardio-skeletal syndrome, Hadziselimovic type, cardiac anomalies-heterotaxy syndrome, polyvalvular heart disease syndrome, Thomas syndrome, 22q11.2 deletion syndrome, myocardial rupture, heart neoplasm, aortopulmonary window, cor biloculare, inflammation of heart layer, myocardial disorder, carcinoid heart disease, omphalocele-diaphragmatic hernia-cardiovascular anomalies-radial ray defect syndrome, coronary microvascular disorder, cardiac ventricle disorder, cardiogenetic disease, cardiogenic shock
Subtypes (10): short QT syndrome, atrioventricular block, sinoatrial node disorder, Wolff-Parkinson-White syndrome, postural orthostatic tachycardia syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular tachycardia, progressive familial heart block, sinoatrial block, NKX2.5-related congenital, conduction and myopathic heart disease
Genetics & variants
GWAS landscape
20 GWAS associations across 14 studies. Top hits map to 4 distinct genes (as reported by GWAS).
Top associations by p-value
| rsID | p-value | Gene | Risk allele | Odds ratio |
|---|---|---|---|---|
| chr4:113528563 | 2e-16 | C | 0.12 | |
| rs34883828 | 1e-14 | CCDC141 | C | 0.06 |
| chr3:38742538 | 6e-14 | C | 0.1 | |
| chr4:114444746 | 2e-13 | T | 0.05 | |
| rs563587066 | 1e-11 | XIRP2 | G | 3.55 |
| rs879389093 | 2e-11 | LINC01644 - LINC00898 | G | 2.37 |
| rs186737131 | 2e-11 | LINC02680 - MKX | C | 3.67 |
| rs548629965 | 3e-11 | LINC03048 | G | 2.45 |
| rs142013827 | 4e-11 | CEP83 | G | 2.39 |
| chr4:23811557 | 2e-10 | T | 0.09 | |
| chr10:103867686 | 1e-09 | T | 0.08 | |
| chr2:63478528 | 2e-09 | T | 1.3 | |
| chr22:31420915 | 1e-08 | T | 2.02 | |
| chrX:24324772 | 2e-08 | A | 1.84 | |
| chr13:93812142 | 2e-08 | T | 0.08 | |
| chr20:62624739 | 2e-08 | C | 1.96 | |
| chr3:32740423 | 3e-08 | G | 2.62 | |
| chr10:26141079 | 4e-08 | G | 3.04 | |
| rs76685789 | 3e-07 | CYCSP6 - RNU6-827P | ? |
Top studies (by case count)
| Study | Lead author | Year | Cases | Controls | Title |
|---|---|---|---|---|---|
| GCST90475952 | Verma A | 2024 | 65,081 | 337,411 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90477905 | Verma A | 2024 | 17,288 | 89,795 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90480164 | Verma A | 2024 | 17,288 | 89,795 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90473563 | UK Biobank Whole-Genome Sequencing Consortium | 2025 | 13,319 | 445,121 | Whole-genome sequencing of 490,640 UK Biobank participants. |
| GCST90667863 | UK Biobank Whole-Genome Sequencing Consortium | 2025 | 13,319 | 445,121 | Whole-genome sequencing of 490,640 UK Biobank participants. |
| GCST90436099 | Zhou W | 2018 | 6,959 | 380,919 | Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies. |
| GCST90477904 | Verma A | 2024 | 5,358 | 49,249 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90477921 | Verma A | 2024 | 1,201 | 446,591 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
| GCST90652075 | Liu TY | 2025 | 989 | 208,597 | Diversity and longitudinal records: Genetic architecture of disease associations and polygenic risk in the Taiwanese Han population. |
| GCST90480160 | Verma A | 2024 | 439 | 120,321 | Diversity and scale: Genetic architecture of 2068 traits in the VA Million Veteran Program. |
Variant details and genetic-evidence tiers
Tier distribution (top 50 variants)
| Tier | Variants |
|---|---|
| Tier 1: coding | 1 |
| Tier 2: splice/UTR | 0 |
| Tier 3: regulatory | 0 |
| Tier 4: intronic/intergenic | 18 |
MAF distribution
| Bucket | Variants |
|---|---|
| common (>=0.05) | 2 |
| low_freq (0.01-0.05) | 0 |
| rare (<0.01) | 5 |
| unknown | 12 |
Functional consequences
| Consequence | Count |
|---|---|
| unknown | 12 |
| intron_variant | 3 |
| intergenic_variant | 3 |
| missense_variant | 1 |
Top variants
| rsID | Chr | Pos | Alleles | MAF | Consequence | Gene | p-value | Tier |
|---|---|---|---|---|---|---|---|---|
| chr4:113528563 | 2e-16 | Tier 4: intronic/intergenic | ||||||
| rs34883828 | 2 | 178905448 | C>A,T | 0.132 | missense_variant | CCDC141 | 1e-14 | Tier 1: coding |
| chr3:38742538 | 6e-14 | Tier 4: intronic/intergenic | ||||||
| chr4:114444746 | 0.255 | 2e-13 | Tier 4: intronic/intergenic | |||||
| rs563587066 | 2 | 167113995 | G>A,C | 0 | intron_variant | XIRP2 | 1e-11 | Tier 4: intronic/intergenic |
| rs879389093 | 22 | 47586023 | G>A | 0.001 | intergenic_variant | LINC01644 - LINC00898 | 2e-11 | Tier 4: intronic/intergenic |
| rs186737131 | 10 | 27638983 | C>T | 0 | intergenic_variant | LINC02680 - MKX | 2e-11 | Tier 4: intronic/intergenic |
| rs548629965 | 17 | 81378194 | G>A,C | 0.001 | intron_variant | LINC03048 | 3e-11 | Tier 4: intronic/intergenic |
| rs142013827 | 12 | 94323419 | G>A | 0.001 | intron_variant | CEP83 | 4e-11 | Tier 4: intronic/intergenic |
| chr4:23811557 | 2e-10 | Tier 4: intronic/intergenic | ||||||
| chr10:103867686 | 1e-09 | Tier 4: intronic/intergenic | ||||||
| chr2:63478528 | 2e-09 | Tier 4: intronic/intergenic | ||||||
| chr22:31420915 | 1e-08 | Tier 4: intronic/intergenic | ||||||
| chrX:24324772 | 2e-08 | Tier 4: intronic/intergenic | ||||||
| chr13:93812142 | 2e-08 | Tier 4: intronic/intergenic | ||||||
| chr20:62624739 | 2e-08 | Tier 4: intronic/intergenic | ||||||
| chr3:32740423 | 3e-08 | Tier 4: intronic/intergenic | ||||||
| chr10:26141079 | 4e-08 | Tier 4: intronic/intergenic | ||||||
| rs76685789 | 2 | 78805841 | A>G | intergenic_variant | CYCSP6 - RNU6-827P | 3e-07 | Tier 4: intronic/intergenic |
Genes & proteins
Mendelian disease overlap and somatic drivers
GenCC: 67 · Orphanet: 16 · OMIM-shared: 0 · Dual-evidence (GWAS+Mendelian): 0
GenCC gene–disease validity (cohort genes)
the Disease column is the GenCC-asserted condition — a cohort gene’s strongest validity may be for a related predisposition syndrome.
| Gene | Classification | Inheritance | Disease | Records |
|---|---|---|---|---|
| EMD | Strong | X-linked | heart conduction disease | 5 |
| TTR | Strong | Autosomal dominant | heart conduction disease | 8 |
| CLCA2 | Moderate | Autosomal dominant | heart conduction disease | |
| TBX5 | Moderate | Autosomal dominant | heart conduction disease | 6 |
| ACTN2 | Limited | Autosomal dominant | heart conduction disease | 10 |
| ANK2 | Limited | Autosomal dominant | heart conduction disease | 11 |
| FLNC | Limited | Autosomal dominant | heart conduction disease | 14 |
| GJA5 | Limited | Autosomal dominant | heart conduction disease | 6 |
| KCNK17 | Limited | Unknown | heart conduction disease | |
| TBX3 | Limited | Autosomal dominant | heart conduction disease | 5 |
Orphanet rare-disease linkage (cohort genes)
| Gene | Orphanet ID | Rare disease |
|---|---|---|
| TBX3 | Orphanet:3138 | Ulnar-mammary syndrome |
| TBX5 | Orphanet:101016 | Romano-Ward syndrome |
| TBX5 | Orphanet:392 | Holt-Oram syndrome |
| TTR | Orphanet:597939 | Euthyroid dysprealbuminemic hyperthyroxinemia |
| TTR | Orphanet:85447 | ATTRV30M amyloidosis |
| TTR | Orphanet:85451 | ATTRV122I amyloidosis |
| ACTN2 | Orphanet:154 | Familial isolated dilated cardiomyopathy |
| ACTN2 | Orphanet:708129 | Autosomal recessive ACTN2-related distal myopathy |
| ACTN2 | Orphanet:708133 | Autosomal dominant ACTN2-related distal myopathy |
| EMD | Orphanet:98863 | X-linked Emery-Dreifuss muscular dystrophy |
| FLNC | Orphanet:171445 | Muscle filaminopathy |
| FLNC | Orphanet:63273 | FLNC-related handgrip and calf weakness-distal myopathy |
| FLNC | Orphanet:75249 | Familial isolated restrictive cardiomyopathy |
| GJA5 | Orphanet:3303 | Tetralogy of Fallot |
| GJA5 | Orphanet:334 | Hereditary atrial fibrillation |
| ANK2 | Orphanet:101016 | Romano-Ward syndrome |
Cohort genes → proteins
10 cohort genes, 10 distinct canonical proteins.
Evidence partition
| Subset | Genes |
|---|---|
| multi_evidence | 10 |
Cohort genes (full)
| Symbol | HGNC | Ensembl | UniProt | Name | Evidence |
|---|---|---|---|---|---|
| TBX3 | HGNC:11602 | ENSG00000135111 | O15119 | T-box transcription factor TBX3 | gencc |
| TBX5 | HGNC:11604 | ENSG00000089225 | Q99593 | T-box transcription factor TBX5 | gencc |
| TTR | HGNC:12405 | ENSG00000118271 | P02766 | Transthyretin | gencc |
| KCNK17 | HGNC:14465 | ENSG00000124780 | Q96T54 | Potassium channel subfamily K member 17 | gencc |
| ACTN2 | HGNC:164 | ENSG00000077522 | P35609 | Alpha-actinin-2 | gencc |
| CLCA2 | HGNC:2016 | ENSG00000137975 | Q9UQC9 | Calcium-activated chloride channel regulator 2 | gencc |
| EMD | HGNC:3331 | ENSG00000102119 | P50402 | Emerin | gencc |
| FLNC | HGNC:3756 | ENSG00000128591 | Q14315 | Filamin-C | gencc |
| GJA5 | HGNC:4279 | ENSG00000265107 | P36382 | Gap junction alpha-5 protein | gencc |
| ANK2 | HGNC:493 | ENSG00000145362 | Q01484 | Ankyrin-2 | gencc |
Cohort function summary
Lead sentence per gene, UniProt-curated.
| Symbol | Protein name | Function (lead sentence) |
|---|---|---|
| TBX3 | T-box transcription factor TBX3 | Transcriptional repressor involved in developmental processes. |
| TBX5 | T-box transcription factor TBX5 | DNA-binding protein that regulates the transcription of several genes and is involved in heart development and limb pattern formation. |
| TTR | Transthyretin | Thyroid hormone-binding protein. |
| KCNK17 | Potassium channel subfamily K member 17 | K(+) channel that conducts voltage-dependent outward rectifying currents upon membrane depolarization. |
| ACTN2 | Alpha-actinin-2 | F-actin cross-linking protein which is thought to anchor actin to a variety of intracellular structures. |
| CLCA2 | Calcium-activated chloride channel regulator 2 | Plays a role in modulating chloride current across the plasma membrane in a calcium-dependent manner, and cell adhesion. |
| EMD | Emerin | Stabilizes and promotes the formation of a nuclear actin cortical network. |
| FLNC | Filamin-C | Muscle-specific filamin, which plays a central role in sarcomere assembly and organization. |
| GJA5 | Gap junction alpha-5 protein | One gap junction consists of a cluster of closely packed pairs of transmembrane channels, the connexons, through which materials of low MW diffuse from one cell to a neighboring cell. |
| ANK2 | Ankyrin-2 | Plays an essential role in the localization and membrane stabilization of ion transporters and ion channels in several cell types, including cardiomyocytes, as well as in striated muscle cells. |
Protein-family classification
Druggable: 2 · Difficult: 3 · Unknown: 5 · Druggable fraction: 0.2
Family distribution
Cohort families vs a genome-wide background (hypergeometric, BH-FDR; fold = observed/expected). Counts kept; sorted by enrichment, so the catch-all Other/Unknown bucket no longer leads.
| Family | Genes | Fold | FDR |
|---|---|---|---|
| Ion channel | 1 | 11.2× | 0.431 |
| Antibody/Immunoglobulin | 1 | 2.9× | 0.561 |
| Scaffold/PPI | 1 | 1.7× | 0.561 |
| Transcription factor | 2 | 1.6× | 0.561 |
| Other/Unknown | 5 | 0.9× | 0.756 |
Per-gene assignment
| Symbol | Family | Druggable? | EC | InterPro (top 3) |
|---|---|---|---|---|
| TBX3 | Transcription factor | no | TF_T-box, p53-like_TF_DNA-bd_sf, TF_T-box_CS | |
| TBX5 | Transcription factor | no | TF_T-box, p53-like_TF_DNA-bd_sf, TF_T-box_CS | |
| TTR | Other/Unknown | no | Transthyretin/HIU_hydrolase, Transthyretin/HIU_hydrolase_d, Thyroxine_BS | |
| KCNK17 | Ion channel | yes | 2pore_dom_K_chnl_TASK, 2pore_dom_K_chnl, K_chnl_dom | |
| ACTN2 | Other/Unknown | no | Actinin_actin-bd_CS, CH_dom, Spectrin_repeat | |
| CLCA2 | Other/Unknown | no | VWF_A, CLCA_chordata, CLCA_N | |
| EMD | Other/Unknown | no | LEM_dom, LEM/LEM-like_dom_sf, LEM_emerin | |
| FLNC | Antibody/Immunoglobulin | yes | Filamin/ABP280_rpt, Actinin_actin-bd_CS, CH_dom | |
| GJA5 | Other/Unknown | no | Connexin, Connexin40, Connexin_N | |
| ANK2 | Scaffold/PPI | no | Death_dom, ZU5_dom, Ankyrin_rpt |
Expression context
Cohort genes with no expression data: 0.
10 cohort genes are a single-cell marker in ≥1 SCXA experiment.
Breadth distribution (Bgee present_calls)
| Bucket | Genes |
|---|---|
| narrow (1-5 tissues) | 0 |
| moderate (6-20) | 0 |
| broad (>20) | 10 |
| unknown | 0 |
Top tissues across cohort
| Tissue | Cohort genes |
|---|---|
| hindlimb stylopod muscle | 2 |
| adrenal cortex | 1 |
| right adrenal gland | 1 |
| right adrenal gland cortex | 1 |
| buccal mucosa cell | 1 |
| cardiac muscle of right atrium | 1 |
| tendon of biceps brachii | 1 |
| choroid plexus epithelium | 1 |
| right lobe of liver | 1 |
| type B pancreatic cell | 1 |
| ascending aorta | 1 |
| descending thoracic aorta | 1 |
| thoracic aorta | 1 |
| skeletal muscle tissue of biceps brachii | 1 |
| skeletal muscle tissue of rectus abdominis | 1 |
| gingiva | 1 |
| gingival epithelium | 1 |
| tongue squamous epithelium | 1 |
| left ovary | 1 |
| left uterine tube | 1 |
Per-gene tissue summary (top 30)
| Symbol | Bgee breadth | FANTOM5 breadth | SCXA | Top tissues |
|---|---|---|---|---|
| TBX3 | 243 | ubiquitous | marker | right adrenal gland cortex, right adrenal gland, adrenal cortex |
| TBX5 | 129 | broad | marker | tendon of biceps brachii, cardiac muscle of right atrium, buccal mucosa cell |
| TTR | 185 | broad | marker | choroid plexus epithelium, type B pancreatic cell, right lobe of liver |
| KCNK17 | 140 | tissue_specific | marker | ascending aorta, thoracic aorta, descending thoracic aorta |
| ACTN2 | 226 | broad | marker | skeletal muscle tissue of rectus abdominis, skeletal muscle tissue of biceps brachii, hindlimb stylopod muscle |
| CLCA2 | 176 | broad | marker | gingival epithelium, gingiva, tongue squamous epithelium |
| EMD | 284 | ubiquitous | marker | left ovary, left uterine tube, popliteal artery |
| FLNC | 255 | ubiquitous | marker | gastrocnemius, hindlimb stylopod muscle, tibialis anterior |
| GJA5 | 190 | broad | marker | placenta, right coronary artery, left coronary artery |
| ANK2 | 281 | ubiquitous | marker | substantia nigra pars compacta, lateral nuclear group of thalamus, substantia nigra pars reticulata |
Protein interactions among cohort
Intra-cohort edges: 4.
Hub genes (top 10 by interactor count)
| Symbol | Interactor count |
|---|---|
| ANK2 | 6,423 |
| TTR | 4,528 |
| EMD | 3,503 |
| FLNC | 3,174 |
| ACTN2 | 2,781 |
| TBX3 | 2,379 |
| TBX5 | 2,250 |
| CLCA2 | 1,559 |
| GJA5 | 1,476 |
| KCNK17 | 521 |
Intra-cohort edges
| A | B | Sources |
|---|---|---|
| EMD | TBX3 | biogrid_interaction |
| GJA5 | TBX3 | string_interaction |
| GJA5 | TBX5 | string_interaction |
| TBX3 | TBX5 | string_interaction |
Structural data
PDB: 7 · AlphaFold-only: 3 · No structure: 0
Cohort genes with PDB structures (top 30)
| Symbol | UniProt | PDB entries |
|---|---|---|
| TTR | P02766 | 462 |
| ACTN2 | P35609 | 16 |
| FLNC | Q14315 | 14 |
| ANK2 | Q01484 | 11 |
| EMD | P50402 | 6 |
| TBX5 | Q99593 | 4 |
| TBX3 | O15119 | 1 |
AlphaFold-only cohort genes (top 30 by pLDDT)
| Symbol | UniProt | pLDDT |
|---|---|---|
| CLCA2 | Q9UQC9 | 86.87 |
| KCNK17 | Q96T54 | 77.25 |
| GJA5 | P36382 | 70.35 |
Function
Pathway analysis
Distinct Reactome pathways touched by cohort: 67. Enrichment computed across 10 evidence-associated genes (10 with Reactome annotation).
Pathways by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 10 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| Pathway | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| Muscle contraction | 3 | 23.1× | 0.016 | TBX5, KCNK17, ACTN2 |
| TWIK-related alkaline pH activated K+ channel (TALK) | 1 | 571.0× | 0.059 | KCNK17 |
| Defective visual phototransduction due to STRA6 loss of function | 1 | 380.7× | 0.059 | TTR |
| Cardiac conduction | 2 | 21.8× | 0.060 | TBX5, KCNK17 |
| Tandem pore domain potassium channels | 1 | 95.2× | 0.069 | KCNK17 |
| CREB1 phosphorylation through NMDA receptor-mediated activation of RAS signaling | 1 | 87.8× | 0.069 | ACTN2 |
| YAP1- and WWTR1 (TAZ)-stimulated gene expression | 1 | 76.1× | 0.069 | TBX5 |
| Depolymerization of the Nuclear Lamina | 1 | 76.1× | 0.069 | EMD |
| Cell-extracellular matrix interactions | 1 | 67.2× | 0.069 | FLNC |
| Physiological factors | 1 | 67.2× | 0.069 | TBX5 |
| Initiation of Nuclear Envelope (NE) Reformation | 1 | 60.1× | 0.069 | EMD |
| Phase 4 - resting membrane potential | 1 | 60.1× | 0.069 | KCNK17 |
| Ras activation upon Ca2+ influx through NMDA receptor | 1 | 57.1× | 0.069 | ACTN2 |
| Unblocking of NMDA receptors, glutamate binding and activation | 1 | 54.4× | 0.069 | ACTN2 |
| Negative regulation of NMDA receptor-mediated neuronal transmission | 1 | 54.4× | 0.069 | ACTN2 |
| The canonical retinoid cycle in rods (twilight vision) | 1 | 51.9× | 0.069 | TTR |
| Nephrin family interactions | 1 | 47.6× | 0.069 | ACTN2 |
| Insertion of tail-anchored proteins into the endoplasmic reticulum membrane | 1 | 47.6× | 0.069 | EMD |
| Long-term potentiation | 1 | 47.6× | 0.069 | ACTN2 |
| Nuclear Envelope Breakdown | 1 | 45.7× | 0.069 | EMD |
| Neuronal System | 2 | 8.8× | 0.069 | KCNK17, ACTN2 |
| Cardiogenesis | 1 | 42.3× | 0.071 | TBX5 |
| Interaction between L1 and Ankyrins | 1 | 36.8× | 0.077 | ANK2 |
| Developmental Biology | 3 | 4.3× | 0.077 | TBX3, TBX5, ANK2 |
| Striated Muscle Contraction | 1 | 30.9× | 0.086 | ACTN2 |
| Gap junction assembly | 1 | 29.3× | 0.087 | GJA5 |
| Assembly and cell surface presentation of NMDA receptors | 1 | 25.4× | 0.095 | ACTN2 |
| Retinoid metabolism and transport | 1 | 24.8× | 0.095 | TTR |
| Post NMDA receptor activation events | 1 | 20.4× | 0.107 | ACTN2 |
| RHOD GTPase cycle | 1 | 20.4× | 0.107 | EMD |
GO biological processes by enrichment
Over-representation of cohort genes vs the genome-wide background (hypergeometric test, Benjamini-Hochberg FDR; fold = observed/expected over 10 annotated cohort genes). Counts and members are kept as ground-truth; sorted by enrichment.
| GO term | Cohort genes | Fold | FDR | Sample cohort genes |
|---|---|---|---|---|
| bundle of His cell to Purkinje myocyte communication by electrical coupling | 2 | 1685.2× | 6e-05 | TBX5, GJA5 |
| atrioventricular bundle cell differentiation | 2 | 1123.5× | 6e-05 | TBX3, TBX5 |
| regulation of atrial cardiac muscle cell action potential | 2 | 1123.5× | 6e-05 | GJA5, ANK2 |
| negative regulation of glomerular filtration | 2 | 842.6× | 9e-05 | TTR, GJA5 |
| SA node cell action potential | 2 | 561.7× | 2e-04 | GJA5, ANK2 |
| atrial septum development | 2 | 421.3× | 2e-04 | GJA5, ANK2 |
| forelimb morphogenesis | 2 | 421.3× | 2e-04 | TBX3, TBX5 |
| regulation of atrial cardiac muscle cell membrane depolarization | 2 | 374.5× | 3e-04 | TBX5, GJA5 |
| atrial septum morphogenesis | 2 | 259.3× | 5e-04 | TBX5, GJA5 |
| ventricular cardiac muscle cell action potential | 2 | 198.3× | 8e-04 | GJA5, ANK2 |
| regulation of cardiac muscle contraction | 2 | 177.4× | 9e-04 | GJA5, ANK2 |
| regulation of ventricular cardiac muscle cell membrane repolarization | 2 | 168.5× | 9e-04 | GJA5, ANK2 |
| cell fate specification | 2 | 105.3× | 0.002 | TBX3, TBX5 |
| ventricular septum development | 2 | 99.1× | 0.002 | TBX5, GJA5 |
| embryonic forelimb morphogenesis | 2 | 99.1× | 0.002 | TBX3, TBX5 |
| ventricular septum morphogenesis | 2 | 86.4× | 0.003 | TBX3, GJA5 |
| embryonic limb morphogenesis | 2 | 80.2× | 0.003 | TBX5, GJA5 |
| mitral valve development | 1 | 1685.2× | 0.003 | GJA5 |
| septum primum development | 1 | 1685.2× | 0.003 | GJA5 |
| atrial ventricular junction remodeling | 1 | 1685.2× | 0.003 | GJA5 |
| positive regulation of cell communication by chemical coupling | 1 | 1685.2× | 0.003 | GJA5 |
| protein localization to T-tubule | 1 | 1685.2× | 0.003 | ANK2 |
| mesoderm morphogenesis | 1 | 1685.2× | 0.003 | TBX3 |
| actin filament uncapping | 1 | 1685.2× | 0.003 | ACTN2 |
| cell migration involved in coronary vasculogenesis | 1 | 1685.2× | 0.003 | TBX5 |
| atrial cardiac muscle cell to AV node cell communication by electrical coupling | 1 | 1685.2× | 0.003 | GJA5 |
| Purkinje myocyte to ventricular cardiac muscle cell communication by electrical coupling | 1 | 1685.2× | 0.003 | GJA5 |
| atrial cardiac muscle cell to AV node cell communication | 1 | 1685.2× | 0.003 | ANK2 |
| SA node cell to atrial cardiac muscle cell communication | 1 | 1685.2× | 0.003 | ANK2 |
| regulation of Purkinje myocyte action potential | 1 | 1685.2× | 0.003 | GJA5 |
Therapeutics
Drug target analysis
Approved (phase 4): 1 · Phase ≥3: 1 · Phased (≥1): 1 · Undrugged: 9
Druggability breadth: 5 of 10 evidence-associated genes (50%) have a ChEMBL target (buckets above are over the deeply-mined display cohort).
Genes with an approved drug
The molecule shown is one approved compound that hits the gene — not necessarily a drug of choice or one indicated for this disease.
| Symbol | Example approved molecule |
|---|---|
| TTR | TRICLABENDAZOLE |
Top cohort targets by molecule count
| Symbol | Molecules | Max phase |
|---|---|---|
| TTR | 29 | 4 |
| TBX3 | 0 | 0 |
| TBX5 | 0 | 0 |
| KCNK17 | 0 | 0 |
| ACTN2 | 0 | 0 |
| CLCA2 | 0 | 0 |
| EMD | 0 | 0 |
| FLNC | 0 | 0 |
| GJA5 | 0 | 0 |
| ANK2 | 0 | 0 |
Drugs targeting cohort genes (top 30)
| Molecule | Max phase | Targets in cohort |
|---|---|---|
| TRICLABENDAZOLE | 4 | TTR |
| AMLEXANOX | 4 | TTR |
| TOLCAPONE | 4 | TTR |
| DICLOFENAC | 4 | TTR |
| LEVOTHYROXINE | 4 | TTR |
| TAFAMIDIS | 4 | TTR |
| BENZIODARONE | 4 | TTR |
| BITHIONOL | 4 | TTR |
| BENZBROMARONE | 4 | TTR |
| ACORAMIDIS | 4 | TTR |
| GEMFIBROZIL | 4 | TTR |
| MECLOFENAMIC ACID | 4 | TTR |
| DASATINIB | 4 | TTR |
| DEXTROTHYROXINE | 4 | TTR |
| TRICLOSAN | 4 | TTR |
| DIFLUNISAL | 4 | TTR |
| CAFFEIC ACID | 3 | TTR |
| RESVERATROL | 3 | TTR |
| EPIGALOCATECHIN GALLATE | 3 | TTR |
| DIACEREIN | 3 | TTR |
| TOLFENAMIC ACID | 2 | TTR |
| LUTEOLIN | 2 | TTR |
| FLUFENAMIC ACID | 2 | TTR |
| XANTHOHUMOL | 2 | TTR |
| GENISTEIN | 2 | TTR |
| NIFLUMIC ACID | 2 | TTR |
| DAIDZEIN | 2 | TTR |
| PTEROSTILBENE | 2 | TTR |
| ACECLOFENAC | 2 | TTR |
Bioactivity and enzyme data
Enzyme cohort genes (≥1 EC): 0.
Cohort genes with ChEMBL bioactivity (full, sorted by assay count)
| Symbol | Assays | Type breakdown |
|---|---|---|
| TTR | 423 | Binding:391, Functional:32 |
| KCNK17 | 2 | Binding:2 |
| TBX5 | 1 | Binding:1 |
| EMD | 1 | Binding:1 |
Cohort genes with high screening signal
≥100 ChEMBL assays — a studied-ness signal; see Therapeutics for approved-drug status.
| Symbol | ChEMBL assays |
|---|---|
| TTR | 423 |
Pharmacogenomics
Cohort genes with a PharmGKB record: 10; with CPIC/DPWG dosing guidelines: 0.
No cohort gene has a CPIC/DPWG genotype-guided dosing guideline (PharmGKB).
Chemical tractability of cohort targets
29 approved/phased compounds have measured bioactivity against a cohort gene (and aren’t yet in disease-level trials). This is a research / tractability signal, NOT a therapeutic recommendation — a bioactivity row often reflects off-target or screening binding (e.g. promiscuous kinase inhibitors against a cohort kinase), implying no disease mechanism.
| Compound | Max phase | Cohort target (bioactivity) |
|---|---|---|
| TRICLABENDAZOLE | 4 | TTR |
| AMLEXANOX | 4 | TTR |
| TOLCAPONE | 4 | TTR |
| DICLOFENAC | 4 | TTR |
| LEVOTHYROXINE | 4 | TTR |
| TAFAMIDIS | 4 | TTR |
| BENZIODARONE | 4 | TTR |
| BITHIONOL | 4 | TTR |
| BENZBROMARONE | 4 | TTR |
| ACORAMIDIS | 4 | TTR |
| GEMFIBROZIL | 4 | TTR |
| MECLOFENAMIC ACID | 4 | TTR |
| DASATINIB | 4 | TTR |
| DEXTROTHYROXINE | 4 | TTR |
| TRICLOSAN | 4 | TTR |
| DIFLUNISAL | 4 | TTR |
| CAFFEIC ACID | 3 | TTR |
| RESVERATROL | 3 | TTR |
| EPIGALOCATECHIN GALLATE | 3 | TTR |
| DIACEREIN | 3 | TTR |
| TOLFENAMIC ACID | 2 | TTR |
| LUTEOLIN | 2 | TTR |
| FLUFENAMIC ACID | 2 | TTR |
| XANTHOHUMOL | 2 | TTR |
| GENISTEIN | 2 | TTR |
| NIFLUMIC ACID | 2 | TTR |
| DAIDZEIN | 2 | TTR |
| PTEROSTILBENE | 2 | TTR |
| ACECLOFENAC | 2 | TTR |
Druggability pyramid
Cohort genes binned by druggability tier (high → low):
| Tier | Definition | Genes | Symbols |
|---|---|---|---|
| A | Approved (phase 4 drug) | 1 | TTR |
| B | Phased (≥1) drug, not yet approved | 0 | |
| C | Druggable family + PDB, no drug | 1 | FLNC |
| D | Druggable family + AlphaFold only, no drug | 1 | KCNK17 |
| E | Difficult family or no structure, no drug | 7 | TBX3, TBX5, ACTN2, CLCA2, EMD, GJA5, ANK2 |
Undrugged target profiles
9 cohort genes are undrugged. Ranked by ‘starting-point quality’ (assay depth + drugged-partner adjacency).
| Symbol | ChEMBL assays | Drugged partners (top 3) |
|---|---|---|
| TBX3 | 0 | — |
| TBX5 | 1 | — |
| KCNK17 | 2 | — |
| ACTN2 | 0 | — |
| CLCA2 | 0 | — |
| EMD | 1 | — |
| FLNC | 0 | — |
| GJA5 | 0 | — |
| ANK2 | 0 | — |
Clinical trials & evidence
Clinical trials
Clinical trials: 0.