Abstract
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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Acknowledgements
G.C. is supported by the National Institute for Health Research (NIHR) Rare Diseases Translational Research Collaboration for the study of LMNA dilated cardiomyopathy (NIHR RD-TRC, #171603), by the European Society of Cardiology (ESC, EACVI), and by NIHR University College London Hospitals Biomedical Research Centre. A.D.H. received support from the University College London Hospitals NIHR Biomedical Research Centre and the British Heart Foundation relevant to this publication (PG/12/29/29497, CS/15/6/31468, and CS/13/1/30327). J.C.M. is directly and indirectly supported by the University College London Hospitals NIHR Biomedical Research Centre and Biomedical Research Unit at Barts Hospital, respectively.
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G.C., A.L.K., and J.C.M. researched data for the article. All the authors discussed the content, wrote the manuscript, and reviewed/edited the article before submission.
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Captur, G., Karperien, A., Hughes, A. et al. The fractal heart — embracing mathematics in the cardiology clinic. Nat Rev Cardiol 14, 56–64 (2017). https://doi.org/10.1038/nrcardio.2016.161
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DOI: https://doi.org/10.1038/nrcardio.2016.161
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