title: Sub-Lingual Spray Versus Pearl of TNG as A Provocative Agent for Tilt Table Test.
abstract: OBJECTIVE
  The aim of this study was to determine the false positive ratio of Tilt Table Test (TTT) result by using TNG spray (Sub-lingual; SL) as compared to TNG pearl in patients referred to military service.
  
  
  METHODS
  This was a prospective study. It was conducted on 110 cases referred for military service, expressed vasovagal symptoms. We divided the subjects into three groups; first Group (60 cases) used TNG pearl for provoking syncope in TTT, Group 2 (50 cases) and Group 3 (control cases) used TNG spray in the same dose (0.4 mg).
  
  
  RESULTS
  In the first step of tilt study, 10%, and 8% of subjects had fainted on not using provoking drug in cases and controls, respectively. After using the drugs, 36.6%, 96% and 18% showed positive results in pearl, spray and the control groups, respectively (p<0.05).
  
  
  CONCLUSIONS
  Rather than pearl group, a 40 minute tilt using TNG spray showed significant higher positive results, which may be incorrectly positive. Using this form of TNG seems not useful for distinguishing and diagnosing vasovagal shocks, especially in subjects referred for military service capacity. For constant evidence, a cross-over clinical trial study is required, involving suspected cases divided into two groups, who both will be examined with spray and pearl.
authors.affiliation: Faculty of Medicine & Cardiovascular Research Center, Department of Cardiovascular Diseases, Baqiyatallah University of Medical Sciences , Tehran, Iran .
authors.forename: Reza
authors.initials: R
authors.lastname: Karbasi-Afshar
authors.forename: Amin
authors.initials: A
authors.lastname: Saburi
authors.forename: Ayat
authors.initials: A
authors.lastname: Shahmari
authors.forename: Arezoo
authors.initials: A
authors.lastname: Khosravi
keywords: Military service; Syncope; TNG spray; Tilt table test