The primary endpoint is a subclinical cardiac outcome defined as follows: between baseline (before RT) and 2 years post RT, a decrease in the global and segmental longitudinal strain or strain rate measured by 2D-STE of at least 5 % and/or an increase in the number of coronary segments containing any plaque measured by CCTA of at least 15 %. These average percentages were chosen based on those observed in previous studies and can be considered clinically pertinent [17, 34–37].
The secondary endpoints are:
Decrease in the strain or strain rate between measurements made before RT and 6 months after RT.
Modified series of biomarkers between the measurements before RT and: just after RT, 6 months after RT, 24 months after RT.
Correlation between the absorbed radiation dose to the whole heart and different structures of the heart and measurements of strain and strain rate and number of coronary segments containing any plaque measured 2 years after RT.
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