Is ACTN2 p.Asn391Ser (c.1172A>G) pathogenic?

ACTN2 p.Asn391Ser (c.1172A>G) is classified Conflicting classifications of pathogenicity in ACTN2 (ClinVar, Conflicting submitters, 6 submitters; last evaluated 2026-09-01). AlphaMissense: likely benign (0.0625); Ultra-rare (popmax 0.0334%, eas); Associated with familial hypertrophic cardiomyopathy.

What condition is associated with ACTN2 p.Asn391Ser (c.1172A>G)?

ACTN2 p.Asn391Ser (c.1172A>G) is associated with familial hypertrophic cardiomyopathy, dilated cardiomyopathy 1AA, myopathy, congenital, with structured cores and z-line abnormalities (ClinVar).

How common is ACTN2 p.Asn391Ser (c.1172A>G) in the general population?

ACTN2 p.Asn391Ser (c.1172A>G) is ultra-rare (popmax 0.0334%, eas) (gnomAD).

What do computational predictors say about ACTN2 p.Asn391Ser (c.1172A>G)?

AlphaMissense predicts likely benign (score 0.0625) — an in-silico prediction, not a clinical call.

ACTN2 p.Asn391Ser

c.1172A>G · rs547711260 · VCV579798

Conflicting classifications of pathogenicity Conflicting submitters

Classification

Conflicting classifications of pathogenicity

ClinVar

Review

Conflicting submitters ★☆☆☆

ClinVar · 6 submitters

AlphaMissense

likely benign

0.0625 · ACMG-weighted

gnomAD v4.1

Rare

ultra-rare (popmax 0.0334%, eas)

Missense predictors

0/3 damaging

AlphaMissense, REVEL, SaProt

Conditions

familial hypertrophic cardiomyopathy

Computational evidence

Protein change
AlphaMissense	0.0625	likely benign
REVEL	0.041	moderately benign-leaning
SaProt	LLR -6.05	tolerated
⇒ AlphaMissense, REVEL and SaProt all call this tolerated.
Splicing
SpliceAI	—	not assessed · no allele here is in the release
Constraint at this position
Conservation	phyloP 6.9	GERP 0.097, phastCons 1
Regional constraint	o/e 0.90	unconstrained · MANE · 25 kb · p 0.0054 · regional, not allelic
Overall
CADD	22.3	PHRED · no single calibrated threshold — expert panels disagree

AlphaMissense carries the ACMG weight for missense; REVEL and SaProt are independent agreement signals.

Population frequency

gnomAD v4.1 · exomes + genomes

Grpmax group 0.0334% East Asian · 15/44,878 alleles

Filtering AF 0.0206% ClinGen BA1/BS1 input FAF95, joint · FAF99 0.0166%

Overall 0.00149% 24/1,614,178 alleles · ultra-rare

Ancestry group	Frequency	1 in
East Asiangrpmax	0.0334%	2,992
African / African-American	0.00533%	18,760
Remaining individualsnot grpmax-eligible	0.0032%	31,254
European (non-Finnish)	0.000254%	393,348

Rarity supports pathogenicity (ACMG PM2); frequency above a disease-specific BA1/BS1 threshold argues against it. A variant frequent in one ancestry group can be near-absent in others, so a single global figure can mislead.

Variant & gene context

Gene: ACTN2
Protein: p.Asn391Ser
Coding: c.1172A>G
MANE Select: NM_001103
dbSNP: rs547711260
Type: single nucleotide variant
Location: chr1:236742960 (GRCh38)
Gene constraint: LOEUF 0.432 · pLI 1.00 (gnomAD)
Structure: AlphaFold pLDDT 84.88 · 18 PDB
Residue 391: a β-strand

Full ACTN2 gene report on Sugi Atlas → Gene function, pathways, protein structure, interactions & more

Disease context

familial hypertrophic cardiomyopathy — disease report on Sugi Atlas → Associated genes, phenotypes, clinical trials & treatments

Also linked: dilated cardiomyopathy 1AA myopathy, congenital, with structured cores and z-line abnormalities myopathy, distal, 6, adult-onset, autosomal dominant

Similar variants

ACTN2 p.Ala119Thr Pathogenic/Likely pathogenic ★★ same condition
ACTN2 p.Leu727Arg Pathogenic/Likely pathogenic ★★ same condition
ACTN2 p.Thr247Met Likely pathogenic ★★ same condition
ACTN2 c.1107+3G>A Uncertain significance ★★ same condition
ACTN2 c.1108-10A>G Uncertain significance ★★ same condition
ACTN2 c.1255+1G>C Uncertain significance ★★ same condition
ACTN2 c.126+2T>G Uncertain significance ★★ same condition
ACTN2 c.127-3C>A Uncertain significance ★★ same condition

Built on 18 open, versioned datasets — ClinVar, gnomAD, AlphaMissense, REVEL, ClinGen & more — plus Sugi Variant's own cross-source analysis. Source data 2026-01–2026-10, ClinVar 2026-10. Full sources & versions →

Cite Sugi Variant

Gür T. Sugi Variant: A Deterministic Per-Variant Germline Reference from a Knowledge Graph for Humans and AI Agents. 2026. doi:10.5281/zenodo.21509445. This variant: https://sugi.bio/variant/actn2-p-asn391ser (accessed [today's date]).

Preprint & method: sugi.bio/variant/method Machine-readable: this page as Markdown