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Nat Rev Cardiol. 2017 Jan;14(1):56-64. doi: 10.1038/nrcardio.2016.161. Epub 2016 Oct 6.

The fractal heart - embracing mathematics in the cardiology clinic.

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UCL Biological Mass Spectrometry Laboratory, Institute of Child Health and Great Ormond Street Hospital, 30 Guilford Street, London WC1N 1EH, UK; and the NIHR University College London Hospitals Biomedical Research Centre, Tottenham Court Road, London W1T 7DN, UK.
Centre for Research in Complex Systems, School of Community Health, Charles Sturt University, Albury, NSW 2640, Australia.
Institute of Cardiovascular Science, University College London, Gower Street, London WC1E 6BT, UK.
International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, London SW3 6LY, UK.
Barts Heart Centre, The Cardiovascular Magnetic Resonance Imaging Unit, St Bartholomew's Hospital, West Smithfield, London, EC1A 7BE, UK.


For clinicians grappling with quantifying the complex spatial and temporal patterns of cardiac structure and function (such as myocardial trabeculae, coronary microvascular anatomy, tissue perfusion, myocyte histology, electrical conduction, heart rate, and blood-pressure variability), fractal analysis is a powerful, but still underused, mathematical tool. In this Perspectives article, we explain some fundamental principles of fractal geometry and place it in a familiar medical setting. We summarize studies in the cardiovascular sciences in which fractal methods have successfully been used to investigate disease mechanisms, and suggest potential future clinical roles in cardiac imaging and time series measurements. We believe that clinical researchers can deploy innovative fractal solutions to common cardiac problems that might ultimately translate into advancements for patient care.

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