Strengths and limitations
All echocardiographic examinations were performed and analysed by
experienced operators and the longitudinal design adds strength to our
findings. However, the examinations were technically challenging in the
obese group and two patients were removed from analysis due to
inadequate quality. Women who attended a minimum of two out of three
scans were included, four women had two rather than three scans (two
from each group). Although the number of women with normal BMI was low,
the findings in that group were consistent with the published
literature.8