Percutaneous thermal ablation of the parathyroid glands is associated with short-term echocardiographic improvements in left ventricular structure and function in patients with end-stage renal disease and secondary hyperparathyroidism

Objective To observe the effects of ultrasound-guided percutaneous thermal ablation of the parathyroid glands on the left ventricular structure and function in patients with end-stage renal disease (ESRD) and secondary hyperparathyroidism (SHPT).Methods Retrospective cohort study (May 2019–March 2025). Patients: thermal ablation (n = 64) vs. medical therapy (n = 115). Propensity score matching (1:1, caliper 0.2) based on gender, age, baseline PTH, serum calcium, left ventricular mass index (LVMI) yielded 108 patients (54/group). Multivariable regression adjusted for residual confounding. Measurements at baseline and 6 months. Changes in LVMI, LVEF, PTH, phosphorus, serum calcium, blood pressure compared.Results After matching, in the thermal ablation group, LVMI, PTH, serum phosphorus, serum calcium, and systolic blood pressure (SBP) at 6 months decreased compared with baseline (all p < 0.05). In the medical therapy group, serum calcium decreased compared with baseline (p < 0.05). Inter-group comparisons showed that the reductions in LVMI, PTH, serum phosphorus, serum calcium, and SBP were greater in the thermal ablation group than in the medical therapy group (all p < 0.05). Multivariable regression analysis showed that thermal ablation was independently associated with a greater percentage reduction in LVMI (95% CI: 7.49–24.44, p < 0.001). In the thermal ablation subgroup with baseline left ventricular systolic dysfunction, LVEF increased from baseline to 6 months (p = 0.017).Conclusion Ultrasound-guided percutaneous thermal ablation of the parathyroid glands was associated with greater reductions in PTH, serum phosphorus, serum calcium, SBP and LVMI than medical therapy. In the pilot subgroup of patients with baseline left ventricular systolic dysfunction, LVEF showed an increase after thermal ablation.