Cardiac Geometry
Overall and in each trimester the LA diameter, IVS, LVEDD, PWT, RWT, LV mass and LV mass index were all higher in the obese compared to the normal BMI group (Table 2, Table S1 and Figure 1). The prevalence of concentric LV hypertrophy (RWT>0.42 and LV mass index >95g/m2) was higher in the obese women in all trimesters (Table 2).

Systolic, diastolic and longitudinal function

There was no difference in EDV index, ESV index or ejection fraction between the groups (Table 3 and Table S1). E/A ratio and TDI E’ lateral reduced with gestation in both groups (Table S2) and women with obesity had lower E/A ratio, TDI E’ at the lateral and medial annulus and higher E/E’ ratio (Table 3, Table S1 and Figure 2), suggesting worse diastolic function, compared to normal BMI women. Longitudinal function of the right heart, assessed by tricuspid annular plane systolic excursion (TAPSE), was lower in women with obesity (Table 3 and Table S1). Left longitudinal function, assessed by mitral annular plane systolic excursion (MAPSE) at the lateral and septal annulus, reduced with gestation in the obese but not in the normal BMI group (Table S2) although there was no significant difference between the groups.