Thierry Rochat

University of Geneva | UNIGE · Department of Internal Medicine

Background The association of obesity and asthma has been described in children and adults. However, whether a different life course of weight in men and women may explain gender differences in asthma incidence, has not been addressed. Objectives Using data from the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults, we inve...

Introduction: Smoking is still the most preventable cause of disease and premature death in Switzerland, as elsewhere. We aimed to assess the main determinants of smoking cessation in the population-based cohort of SAPALDIA (Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults). Methods: The SAPALDIA study was initiated in 1...

Background: In non-small-cell lung cancer patients, high peak oxygen uptake (peak V̇O2 ) predicts lower rates of postoperative complications and better long-term survival. Neoadjuvant chemotherapy (NAC) may negatively impact peak V̇O2 . Methods: Cardiopulmonary exercise testing (CPET) was performed in 34 consecutive stage IIIA/IIIB non-small-cel...

Non-infectious pulmonary complications following hematopoietic stem cell transplantation are entities occuring early or late, depending on whether they occur before or after 100 days post-transplantation. They have firstly to be differentiated from infectious complications, which is not always easy, as their clinical and radiological aspects can mi...

The diagnosis of occupational asthma (OA) can be challenging and needs a stepwise approach. However, the predictive value of the methacholine challenge has never been addressed specifically in this context. We sought to evaluate the sensitivity, specificity, and positive and negative predictive values of the methacholine challenge in OA. A Canadian...

A higher incidence of asthma is reported in women compared with men, but evidence in later adulthood is limited. We aimed to determine the 20-year cumulative incidence of adult asthma in Switzerland and its relation to sex, taking into account age and allergic sensitisation.We assessed incidence of self-report of doctor-diagnosed asthma between 199...

Air pollutants (AP) play a role in subclinical inflammation, and are associated with cardiovascular morbidity and mortality. Metabolic syndrome (MetS) is inflammatory and precedes cardiovascular morbidity and type 2 diabetes. Thus, a positive association between AP and MetS may be hypothesized. We explored this association, (taking into account, pa...

The Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults (SAPALDIA), a population cohort study, used heated-wire spirometers in 1991 and 2002 and then ultrasonic spirometers in 2010 revealing measurement bias in healthy never smokers. To provide a practical method to control for measurement bias given the replacement of spiromet...

Short-term exposure to air pollution has adverse effects among patients with asthma, whether long-term exposure to air pollution is a cause of adult-onset asthma is unclear. To investigate the association between air pollution and adult onset asthma. Asthma incidence was prospectively assessed in six European cohorts. Exposures studied were annual...

Indoor air quality is a growing concern as we spend the majority of time indoors and as new buildings are increasingly airtight for energy saving purposes. For a better understanding of residential indoor air pollution in Switzerland we conducted repeated 1-2-week-long indoor and outdoor measurements of particle number concentrations (PNC), particu...

Background: Registries are important for real-life epidemiology on different pulmonary hypertension (PH) groups. Objective: To provide long-term data of the Swiss PH registry of 1998-2012. Methods: PH patients have been classified into 5 groups and registered upon written informed consent at 5 university and 8 associated hospitals since 1998....

Background: There is an increasing interest in oscillometric arterial stiffness measurement for cardiovascular risk stratification. We assessed reproducibility of the cuff-based arterial stiffness measures cardio-ankle vascular index (CAVI), brachial-ankle pulse wave velocity (baPWV) and peripheral augmentation index (pAI) in a subsample of the se...

In 2014, among new therapeutic approaches in pulmonary medicine, the role of inhaled corticosteroids has to be revaluated after the publication of the WISDOM and other studies. Their prescription should no longer be systematic even for "at risk" groups of patients, as defined by the GOLD consensus, but rather be considered on an individual basis. I...

Objective: To determine whether CT pulmonary angiography (CTPA) using low mA setting reconstructed with model-based iterative reconstruction (MBIR) is equivalent to routine CTPA reconstructed with filtered back projection (FBP). Methods: This prospective study was approved by the institutional review board and patients provided written informed...

Bronchial thermoplasty is a recent endoscopic technique for the treatment of severe asthma. It is an innovative treatment whose clinical efficacy and safety are beginning to be better understood. Since this is a device-based treatment, the evaluation procedure of risks and benefits is different that for pharmaceutical products; safety aspects, regu...

Bronchial thermoplasty is a young yet promising treatment for severe asthma whose benefit for long-term asthma control outweighs the short-term risk of deterioration and hospitalisation in the days following the treatment. It is an innovative treatment whose clinical efficacy and safety are beginning to be better understood. Since this is a device-...

Aspergillus pulmonary infection causes a spectrum of diverse diseases according to host immunity. The two major entities are invasive pulmonary aspergillosis and chronic pulmonary aspergillosis. The later can be divided into aspergilloma, then into chronic cavitary, more or less fibrosing aspergillosis, and finally into chronic necrotizing aspergil...

Chronic cough is one of the most common symptoms for which outpatient care is sought. The most frequent causes are upper airway cough syndrome, asthma, and gastroesophageal reflux. It is often difficult to determine the origin of chronic cough based on the medical history and physical examination. Empirical treatment directed at the three aforement...

The chronic impact of ambient air pollutants on lung function in adults is not fully understood. The objective of this study was to investigate the association of long-term exposure to ambient air pollution with lung function in adult participants from five cohorts in the European Study of Cohorts for Air Pollution Effects (ESCAPE). Residential exp...

Background: Both air pollution and genetic variation have been shown to affect lung function. Their interaction has not been studied on a genome-wide scale to date. Objectives: We aimed to identify, in an agnostic fashion, genes that modify the association between long-term air pollution exposure and annual lung function decline in an adult populat...

Background This study aimed to assess associations of outdoor air pollution on prevalence of chronic bronchitis symptoms in adults in five cohort studies (Asthma-E3N, ECRHS, NSHD, SALIA, SAPALDIA) participating in the European Study of Cohorts for Air Pollution Effects (ESCAPE) project. Methods Annual average particulate matter (PM10, PM2.5, PMabso...

Objective: Manifestation of cardiovascular disease (CVD) occurs with clear sex differences. Carotid stiffness (CS) parameters are increasingly used for CVD risk assessment but the sex-specific association with CVD risk factors as well as association patterns between CS parameters are largely unknown, which we investigated in SAPALDIA population-ba...

Background: We present long-term epidemiological insights from the Swiss pulmonary hypertension-(PH)-registry 1998 – 2012. Methods: PH-patients were registered at 13 hospitals and classification, severity and therapy noted. Patients were regularly followed for events (death, transplantation, lost-to follow-up). Analyses were stratified according t...

Improved air quality has been found associated with attenuated age-related decline in lung function. But whether genetic polymorphisms strongly associated with lung function play a modifying role in this attenuation process has so far not been investigated. We selected ten single nucleotide polymorphisms derived from the largest genome-wide associa...

The role of air pollution in chronic obstructive pulmonary disease (COPD) remains uncertain.The aim was to assess the impact of chronic exposure to air pollution on COPD in four cohorts using the standardised ESCAPE exposure estimates. Annual average particulate matter (PM), nitrogen oxides (NOx) and road traffic exposure were assigned to home addr...

Nighttime traffic noise is associated with sleep disturbances, but sleep fragmentation and sleep-disordered breathing (SDB) have not been demonstrated in individuals living near busy roads. We asked 1383 participants to answer a health questionnaire and to undergo 24-h electrocardiogram (ECG). Nocturnal ECG records were used to calculate the very l...

Background: Electromagnetic navigation bronchoscopy (ENB) is an emerging endoscopic technique for the diagnosis of peripheral lung lesions. A thorough analysis of ENB's yield and safety is required for comparison to other sampling modalities. Objectives: To describe ENB's yield and safety profile. Methods: The MEDLINE and EMBASE databases were syst...

We thank Preiksaitis and Limaye for their comments on our paper1 and their interest and we attempt to provide herewith responses to their questions. First, they correctly note that we did not find an association between viral infection and acute rejection in our lung transplant recipient (LTR) cohort.2 However, this finding does not preclude a poss...

Carotid intima media thickness (CIMT) and local stiffness are vascular biomarkers of atherosclerotic burden. We investigated the variability and reproducibility of clinically relevant structural (CIMT, lumen diameter) and functional parameters (strain, distensibility, compliance, β-stiffness index, Peterson's elastic modulus and Young's elastic mod...

Bronchiectasis is a condition defined by permanent dilation of the bronchi, either idiopathic or associated with other disease states. Diagnostic workup for bronchiectasis is essential in determining management and treatment. For diffuse bronchiectasis, we propose a workup plan that includes testing for humoral immunodeficiency by measuring serum I...

Cryptogenic organizing pneumonia (COP) is a distinct clinico-pathologic entity described for the first time by Davison in 1983 and 2 years later by Epler under the name of idiopathic Bronchiolitis Obliterans Organizing Pneumonia (BOOP). It most often presents with the clinical and radiological features of an infectious pneumonia which fails to resp...

Two historical randomized controlled trials have demonstrated that chemo-radiotherapy offers the best survival advantage over surgery in small cell lung carcinoma (SCLC) and led to abandon surgery for the treatment of SCLC. Yet, widespread use of CT scanning increases the detection of early and very early stage SCLC. Therefore, the traditional 2 st...

We evaluated interactions between SERPINA1 PiMZ genotype, associated with intermediate α1-antitrysin deficiency, with outdoor particulate matter ≤10 µm (PM10), and occupational exposure to vapours, dusts, gases and fumes (VGDF), and their effects on annual change in lung function. Pre-bronchodilator spirometry was performed in 3739 adults of the Sw...

Bilirubin is a strong antioxidant. Increased serum levels were associated with respiratory disease and mortality risk. We studied the association of bilirubin with lung function in the SAPALDIA cohort.Associations between natural logarithmized bilirubin and forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC,...

Cigarette smoking is a prevalent risk behavior among adolescents and tracks into adulthood. Little is known on the early impact of smoking on the vasculature in adolescence, although smoking is considered highly atherogenic in adults. We investigated the association between active smoking and Carotid artery Intima Media Thickness (CIMT), an early i...

The incidence and outcomes of respiratory viral infections in lung transplant recipients (LTR) are not well defined. The objective of this prospective study conducted from June 2008 to March 2011 was to characterise the incidence and outcomes of viral respiratory infections in LTR. Patients were seen in three contexts: study-specific screenings cov...

Objective: Hypertension is a major risk factor of cardiovascular events. To identify potential sex specific differences in the association of prior blood pressure (BP) to arterial stiffness, we studies the relative change of lumen diameter for a given pulse pressure (distensibility) in participants of the SAPALDIA cohort study. Methods: In the fir...

Purpose: Cardiovascular mortality has a close association with body mass index (BMI). A subclinical vascular biomarker for atherosclerosis is the elastic modulus introduced by Peterson (EP). However, whether BMI is associated with EP has not been investigated. Therefore, the aim of the study was to investigate the association of prior BMI and curre...

Purpose: This nested study of the second follow-up of the Swiss Cohort Study on Air Pollution and Lung and Heart Diseases in Adults (SAPALDIA 3) aimed at analysing the reproducibility of the arterial stiffness marker cardio-ankle vascular index (CAVI) in Caucasians. Methods: In 105 persons aged 50-80yrs (50 males, 55 females, 63.0±6.9yrs) two measu...

Background: Hypertension has become the leading risk factor contributing to the global disability adjusted life years. Adolescent hypertension is increasing, possibly due to the obesity epidemic, and is known to track into adulthood. The SAPALDIA Youth Study, a nested study within the adult Swiss Air Pollution And Lung and Heart Disease In Adults c...

Several infrequent genetic polymorphisms in the SERPINA1 gene are known to substantially reduce concentration of alpha1-antitrypsin (AAT) in the blood. Since low AAT serum levels fail to protect pulmonary tissue from enzymatic degradation, these polymorphisms also increase the risk for early onset chronic obstructive pulmonary disease (COPD). The r...

Air pollution and obesity are hypothesized to contribute to accelerated lung function decline with age through their inflammatory properties. We investigated whether the previously reported association between improved air quality and lung health in the population-based SAPALDIA cohort is modified by obesity. We used adjusted mixed-model analyses t...

Rationale: The temporal stability of adult asthma phenotypes identified using clustering methods has never been addressed. Longitudinal cluster-based methods may provide novel insights in the study of the natural history of asthma. Objectives: To compare the stability of cluster-based asthma phenotype structures a decade apart in adults and to a...

Both asthma and obesity are complex disorders that are influenced by environmental and genetic factors. Shared genetic factors between asthma and obesity have been proposed to partly explain epidemiological findings of co-morbidity between these conditions. To identify genetic variants that are associated with body mass index (BMI) in asthmatic chi...

BACKGROUND: Long-term cohort studies and lung function laboratories are confronted with the need for replacement of spirometers. Lack of agreement between spirometers might affect the longitudinal comparison of data, notably when replacing conventional by portable spirometers. OBJECTIVES: To compare the handheld EasyOne (EO) with the conventional S...

The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements ar...

This review reports on papers published in 2012 that will most likely impact on daily medical practice in four different areas of pulmonary medicine. How should treatment of asthma with inhaled corticosteroids be adjusted on the long run? Should idiopathic pulmonary fibrosis receive treatment with immunosuppressive drugs? Is a long-term treatment w...

OBJECTIVE: The molecular mechanisms underlying the association between obesity (BMI ≥ 30 kg/m(2)) and asthma are poorly understood. Since shifts in the fate of bronchial cells due to low-grade systemic inflammation may provide a possible explanation, we investigated whether two of the best documented functional variants in cell cycle control genes...

Genome-wide association studies have identified numerous genetic loci for spirometic measures of pulmonary function, forced expiratory volume in one second (FEV(1)), and its ratio to forced vital capacity (FEV(1)/FVC). Given that cigarette smoking adversely affects pulmonary function, we conducted genome-wide joint meta-analyses (JMA) of single nuc...

Increasing carotid stiffness is associated with an ascending atherosclerotic risk and cardiovascular events. Therefore early risk detection can prevent stroke and myocardial infarction. We analyzed ultrasound clips of average strain over a standardized 1cm-segment over at least one heart cycle in 1929 participants of the SAPALDIA3 cohort study (mea...

Strong scientific evidence has shown that ordinary peaks of outdoor air pollution worsen the symptoms and control of asthma. As for chronic exposure, elevated mean level of local, near-road air pollution may cause increased incidence of asthma among children, and probably also among adults. By contrast, while there is no doubt that air pollution wo...

Whether underlying chronic respiratory diseases are susceptible factors for symptomatic episodes, which lead to primary-level care, in association with air pollutant exposures is unknown. We evaluated and compared association lag structures between daily ambient levels of nitrogen dioxide (NO2) and total suspended particulates (TSP) and respiratory...

BACKGROUND: Premature atrial contractions (PACs) are independent predictors of atrial fibrillation, stroke, and death. However, little is known about PAC frequency in the general population and its association with other cardiovascular risk factors. METHODS AND RESULTS: We performed a cross-sectional analysis among participants of the population-ba...

We report a case of postural tachycardia syndrome occurring after the surgical correction of an aortic coarctation, and coexisting with upper airway resistance syndrome. A 29-year-old Caucasian man complained of extreme fatigue, daytime sleepiness, shortness of breath on exertion, light-headedness and general weakness on standing. These symptoms be...

Severe alpha1-antitrypsin (AAT) deficiency is a strong risk factor for COPD. But the impact of gene variants resulting in mild or intermediate AAT deficiency on the longitudinal course of respiratory health remains controversial. There is indication from experimental studies that pro-inflammatory agents like cigarette smoke can interact with these...

Rationale: Genome-wide association studies (GWAS) have identified loci influencing lung function, but fewer genes influencing chronic obstructive pulmonary disease (COPD) are known. Objectives: Perform meta-analyses of GWAS for airflow obstruction, a key pathophysiologic characteristic of COPD assessed by spirometry, in population-based cohorts exa...

Background Oxidative stress related genes modify the effects of ambient air pollution or tobacco smoking on lung function decline. The impact of interactions might be substantial, but previous studies mostly focused on main effects of single genes.Objectives We studied the interaction of both exposures with a broad set of oxidative-stress related c...

Household cleaning products are associated with adverse respiratory health outcomes, but the cardiovascular health effects are largely unknown. We determined if long-term use of household sprays and scented products at home was associated with reduced heart rate variability (HRV), a marker of autonomic cardiac dysfunction. We recorded 24-hr electro...