Heart Rate Variability During Acute Diverticulitis

Study Overview
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Brief Summary
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The purpose of this study is to investigate heart rate variability during Acute uncomplicated diverticulitis by ECG-monitor (Holter), the investigators hypothesis is the inflammation causes a decrease of High Frequency(HF)-power component of heart rate variability and this correlates with sleep quality and daytime fatigue.

Detailed Description
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An increasing number of studies have shown that circadian variation in the excretion of hormones, the sleep-wake cycle, the core body temperature, the tone of the autonomic nervous system and the activity rhythm are important both in health and disease processes. The investigators are interested in investigating the heart rate variability (HRV) during an acute surgical non-inflammatory condition, and to exam whether there are correlations between: HRV and sleep stages, HRV and cytokine levels in blood and HRV and subjective fatigue. Following methods will be applied Device: Holter monitor - Medilog AR12 (Oxford Instruments, Oxford, England) Other: Karolinska Sleepiness Scale Other: Physical Fatigue Scale Device: Polysomnograph - Embla Titanium (Natus Medical Incorporated, USA) Procedure: Plasma cytokines (IL-2, IL-6 and TNF(tumor necrosis factor)-alfa) Procedure: Plasma CRP(C reactive protein) and leukocytes

Official Title
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Heart Rate Variability in the Course of Acute Uncomplicated Diverticulitis

Conditions
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Acute Diverticulitis

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: CT-verified diverticulitis patients managed by antibiotic treatment at Herlev Hospital Pain and fever occurred less than 72 hours prior to the admission ASA (American Society of Anesthesiologists) score I to III Exclusion Criteria: Surgical intervention needed Complicated diverticulitis Complications in relation to diverticulitis Pain and fever occurred more than 72 hours prior to the admission In anticoagulant treatment and heart rate control treatment Known Autoimmune disease Known medically treated sleep-disorder (insomnia, restless legs etc.) and sleep apnea Shift-work or jetlag Daily use of opioid, psychopharmaca, opioids or anxiolytics (including Hypnotics) Known psychiatry conditions in treatment with psychopharmaca Daily alcohol intake of more than 5 units or drug abuse Missing written consent Diabetes Mellitus Predicted bad compliance Pregnant or breast-feeding Urine or fecal incontinence Severe kidney disease Current cancer

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 75 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| acute uncomplicated diverticulitis<br>CT-verified acute uncomplicated diverticulitis managed by antibiotics | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart-rate variability changes during the acute uncomplicated diverticulitis compared to the baseline levels at 30th night where the condition has been cured | Heart-rate variability measured by Holter monitor and a following analysis of frequency and time domain parameters. | 1st, 2nd and 30th night following the admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| changes in plasma cytokine levels during the acute uncomplicated diverticulitis from the baseline levels at 30th day (remission) | the blood sample is taken at night before sleep time. the cytokines are measured with ELISA-kit | 1st, 2nd and 30th days following the admission | 
| change in Sleep data during the acute diverticulitis from baseline Sleep data at remission (30th day) | Sleep data is measured by Polysomnography and sleep is categorized into sleep stages (awake, stage 1, 2, REM-sleep and SWS-sleep) | 1st, 2nd and 30th days following the admission |