In a maverick method, nephrologist Michael Field taught medical students to decipher different heart murmurs using their stethoscopes, trills, appoggiatures, and decrescendos to describe the distinctive sounds of heart valves closing and blood flowing. flows through the leaky valves in the plumbing troubles of the heart. .
Separately, in music based on electrocardiographic (ECG) traces of heart rhythm disturbances, one of us, musician and mathematician Elaine Chew, has used musical notation to capture the characteristic rhythms of electrical abnormalities in the heart. Collage from existing music fragments corresponding to heartbeats, Brubeck’s Turkish blue rondo provided the 2: 4: 3 rhythmic tattoo of the first ventricular beats, Piazzolla The Grand Tango remixed produced the irregular rhythms of atrial fibrillation. Small Piano Studies, with instructional descriptions from cardiologist Pier Lambiase, provided a layman’s introduction to electrical aberrations of the heart.
The reason these heart-to-music mappings work is that abnormal heart rhythms tend to form simple ratios between beats and intervals. In fact, the distinctive rhythms of Beethoven’s music so closely resemble those of cardiac arrhythmias that cardiologists have speculated that they could be transcriptions of Beethoven’s possible arrhythmia, his interoceptive awareness of his own rhythm. heart strengthened by his deafness.
This is just one of the many reasons why music should be a part of every cardiologist’s toolbox. Music and the heart have been romantically linked in popular consciousness due to their common connection with human emotions and the brain. History is replete with examples of emotionally charged events followed almost immediately by the person’s death. Surgeon John Hunter uttered the famous phrase, “My life is at the mercy of any scoundrel I should be passionate about,” before collapsing and dying after a heated meeting in the council chamber.
Cardiologists Peter Taggart and Pier Lambiase have studied how emotions alter the conductive properties of individual heart cells. Mental stress changes the recovery period of heart cells after each heartbeat, called the action potential duration. Taggart is the co-author of a study in which patients whose hearts have been paced at a steady rate watch the heart-wrenching “cut the rope” scene in Vertical Limit (2000). The duration of the action potential of patients was shortened under stress. This may explain how more extreme stress associated with underlying heart disease could precipitate life-threatening arrhythmias.
Acute stress produces dramatic effects on the heart, but slow-burning chronic stress from prolonged insecurity also predisposes people to illness and death. The sympathetic nervous system’s default state of alertness is suppressed when security is perceived; these safety brakes are lifted under duress. Generalized Stress Insecurity Theory co-authored by psychophysiologist Julian Thayer connects unconsciously perceived insecurity with prolonged stressors such as low social status, early life adversity or loneliness to the hypervigilance that increases the risk of developing heart disease.
Music moves us in part because it taps into our primitive intuitions about the heartbeat. Until the mid-19th century, when it was replaced by the mechanical metronome, the human heartbeat was the standard unit of measure for musical time. In his treaty of 1496, the Musical practice, composer-theorist Franchinus Gaffurius wrote that the appropriate measure of musical rhythm should be the pulse of a healthy human being, noting that the pulse of “people with a fever” either increases or becomes uneven in a way that disturbs the doctors.
When we connect with the pulse of music, we feel the physiological states of others. The regular pulse at the beginning of Schubert Trio, op. 100, defines a strong but serene rhythm for its bewitching melody. The panting octaves of the opening of Der Erlkrönig evokes the rapid heart palpitations of the feverish boy in his father’s arms, galloping through the stormy, windswept night. In a study co-authored by musician and scientist Grace Leslie, it was found that just hearing heartbeats, pulse-only music, increases listeners’ ability to feel what others are feeling.
Music changes our heart rate, breathing and blood pressure, and changes the variability of our heart rate, indicators of heart and mental health. Neuroscientist Psyche Loui and her colleagues have traced the physiological changes induced by music to a central node in brain networks, called the anterior insular, with dense connections with the vagus nerve, responsible for the unconscious regulation of bodily functions.
The anterior insula is associated with an empathetic mirroring of external and internal experiences. It is also connected to the parts of the brain responsible for hearing (the auditory cortices) and pleasure (the dopamine reward system). These auditory and reward network pathways likely underlie the mind’s ability to form predictions and expectations while listening to music. The systematic fulfillment and violation of expectations is believed to underlie the emotion and meaning of music.
Music is an ideal catalyst for inducing physiological changes in heart-brain studies, as it can be systematically dissected into characteristics based on the content of the notes and how that content is communicated in the performance. Evidence suggests that these musical attributes trigger brain responses at a basic level. By analyzing listeners ‘brain imaging data in the OpenFMRI Study Forrest dataset, composer and neuroscientist Michael Casey found that specific musical characteristics induce predictable activation patterns in listeners’ brain regions. The activation patterns were consistent enough that the machines could infer the music heard by the listener or their genre simply from their fMRI scans.
Musical characteristics have also been linked to physiological responses. In a study co-authored by doctors Luciano Bernardi and Peter Sleight, the increased volume of vocal and orchestral music produced vascular constriction and an increase in blood pressure proportional to these crescendos. Verdi’s tunes with ten-second phrases – Mayer’s wave period, the body’s natural oscillation of blood pressure – synchronized listeners’ heart and respiratory signals with the musical envelope. It is believed that such unconscious physiological responses are the progenitors of music-induced emotions.
Music also has a common impact on human physiology. People who listen to the same music tend to synchronize not only their movements, but also their breathing and heart rhythms. Some of this heartbeat consistency is due to joint breathing, but the partial consistency (linear relationships) remained higher between the heartbeats of people vocalizing long notes together, versus baseline, or breathing together, even after removing the effect of breathing.
The cognitive and physical demands of music also have measurable effects on musicians’ heart rhythms and breathing patterns. Psychologists Caroline Palmer and Shannon Wright have shown that the repetitiveness of musicians’ heart rhythms shows greater rigidity (predictability) when playing unfamiliar musical melodies, and also when playing in the first hour after waking up in the morning rather. that evening.
For heart patients, musical interventions can also modulate cerebral blood flow, reduce preoperative anxiety and postoperative stress, improve surgery results, and lower cortisol levels. It is found that musical interventions significantly affect heart rate and blood pressure in patients with coronary artery disease. Listening to relaxing music not only lowers heart and respiratory rates, but also the heart’s oxygen demand in patients who have had a heart attack.
Technological advancements in biofeedback sensors mean that physiological parameters such as heartbeat and heart rate variability can be harnessed to guide musical interventions in heart therapy. Physiological feedback can be used to select or shape music to influence listeners’ heart rate and breathing, for example, to increase heart rate variability. With the widespread adoption of biofeedback devices, tailoring musical interventions to individual cognitive or neurocardiac states is now within reach, enabling ‘musical prescription’ for enhanced mental and physical well-being.
This is an opinion and analysis article; the opinions expressed by the author or authors are not necessarily those of American scientist.
This article was developed from an exploratory multidisciplinary seminar on music and the heart at Harvard University’s Radcliffe Institute for Advanced Study involving physicians, neuroscientists, and musicians with a particular interest in music and its effects on human physiology.
The work of EC and PDL is supported in part by the European Research Council (ERC) under the European Union’s Horizon 2020 research and innovation program (grant agreements n ° 788960 and 957532) .
EL’s work is supported in part by the National Science Foundation (NSF) under NSF STTR Phase I Grant # 2014870. All opinions, findings and conclusions or recommendations expressed herein are those of the authors and do not necessarily reflect those of funders.