Jan. 09--Whether or not music stirs inside, each of us bears a living metronome at our core. It may tick at 40 or 100 beats per minute, in three-quarter time or in six-eight, erratically or like a Swiss clock. Hear it or not, the human heart quietly marks the rhythm of our lives.
A new study focusing on the music of Ludwig van Beethoven treats shifting musical rhythms as a sort of musical electrocardiogram. In Beethoven's dotted rhythms, tempo shifts, sudden pauses and composition notes, a trio of researchers suggest that they have gleaned the distant echo of the composer's heart.
Where most merely hear greatness, they hear cardiac arrhythmia.
Beethoven, the tragic musical genius who died, deaf, at age 56, lived with a heart that was, figuratively at least, broken many times over. Although definitive diagnoses died with him, music historians have speculated that he suffered from a wide range of medical conditions, including alcohol-induced cirrhosis, lead poisoning and syphilis.
Beethoven's heart was found structurally sound upon autopsy in 1827. But in an article published recently in the journal Perspectives in Biology and Medicine, the authors -- a cardiologist, an internal medicine specialist and a musicologist -- cite the rhythmic turnabouts in three of the master's compositions to diagnose, via "musical electrocardiogram," the irregular heartbeat of a man as beset by physical and psychic afflictions as he was blessed with musical genius.
What is clear from his personal letters and notes is that Beethoven began to lose his hearing around 1800, at the age of 30. He composed the bulk of his music even as the sounds of the world around him dimmed -- and that, say the authors of the new study, may have made him exquisitely attuned to his own heartbeat. Some of his most haunting and ambitious works -- the late string quartets, the Mass in D minor (Missa Solemnis), the Ninth Symphony in D minor -- were composed after he became completely deaf in 1819.
"This is entirely speculative," says University of Washington cardiologist Zachary D. Goldberger, who coauthored the paper with musicologist Steven M. Whiting and internal medicine specialist Joel D. Howell, both of the University of Michigan. "At least it gives us a new dimension by which to listen to his music."
Goldberger said the three were drawn to focus on the rhythmic shifts and punctuations of three Beethoven compositions that have been characterized by musicologists as particularly abrupt, dramatic or unusual in music of Beethoven's time -- the Piano Sonata in E flat major (Opus 81a, called "Les Adieux"), the String Quartet No. 13 in B flat major (Opus 130) and the Piano Sonata No. 12 in A flat major (Opus 110).
The authors note the "distinctive 'galloping' rhythm" of the Sonata in E flat major's adagio section and hear slow, irregular heartbeats, followed by "racing irregular heartbeats," in the allegro section that follows.
In the String Quartet No. 13, the authors hear, in a seven-measure section in the middle of the fifth movement (called the Cavatina), "a short paroxysm of an atrial tachyarrhythmia." They cite Beethoven's notation: that the passage should be played "beklemmt," or "heavy of heart." And they point to pianist Jonathan Biss' 2011 observation that the section always evoked a sensation of shortness of breath.
In the third movement of the Piano Sonata No. 12 in A flat major, the authors point to an "arioso dolente" (or lamenting song) preceding one of two fugues. The left hand plays a repetitive run of notes that "bears some resemblance to rapid tachyarrhythmia," they note. The right hand, simultaneously, plays an irregularly punctuated melody that "bears some resemblance to dyspnea," or shortness of breath, "which would not be an unusual sensation for someone experiencing a tachyarrhythmia."
"When your heart beats irregularly from heart disease, it does so in some predictable patterns," said coauthor Howell, a professor of internal medicine. "We think we hear some of those same patterns in his music."
Beethoven's litany of physical woes clearly predisposed him to atrial fibrillation, atrial flutter or even multifocal atrial tachycardia, the authors write. But they acknowledge that their observations are far from proof of those conditions. "Similar rhythmic intricacies" are found in other works by many composers, they add, and cardiac arrhythmia can hardly be ascribed to all who use irregular syncopation.
"However, in highly charged passages of certain pieces, the possibility of cardiac arrhythmia can lend a quite physical aspect to one's interpretation of the music in question," they wrote. "These passages can seem, in an unexpectedly literal sense, to be heartfelt."
