Heartflow Raises 2026 Outlook After Growth Accelerates
Second-quarter revenue reached $64.1 million, up 48% from a year earlier, and the company lifted full-year 2026 guidance to $246 million to $250 million.
Heartflow, Inc. (HTFL), the maker of AI software for diagnosing coronary artery disease, raised its full-year 2026 revenue outlook to $246 million to $250 million, or about 40% to 42% growth, after second-quarter sales growth accelerated to 48% from a year earlier.
That is the second consecutive lift. With first-quarter results, the company had already moved the range from $218 million to $222 million, or about 24% to 26% growth, to $228 million to $232 million, or about 29% to 32% growth.
Total revenue was $64.1 million in the three months ended June 30, 2026, after 41% year-over-year growth in the first quarter and 40% in the fourth quarter of 2025. U.S. revenue was $59.6 million, up 51% from a year earlier. International and other revenue was $4.5 million, up 12%.
The year-over-year increase in total global revenue was primarily attributable to higher U.S. FFRCT case volume and higher U.S. Plaque case volume. In the first quarter, the increase was attributed primarily to U.S. FFRCT volume.
President and CEO John Farquhar said the FFRCT business remains strong and durable and that Plaque is rapidly emerging as a meaningful second growth engine, helping the company win new accounts and deepen physician utilization. Plaque adoption was described as ramping ahead of schedule in the first-quarter release.
Gross margin was 83.0%, or 83.3% on a non-GAAP basis, compared with 75.5% and 75.6% a year earlier. Gross profit was $53.2 million. The year-over-year expansion was primarily attributable to higher total revenue case volume, higher U.S. Plaque case volume, and improved production-team productivity from AI efficiency initiatives, partially offset by hiring and training of production personnel.
GAAP net operating loss was $17.9 million. Non-GAAP net operating loss was $7.9 million, versus $15.5 million in the first quarter, which included a $7.5 million non-cash impairment charge tied to facilities optimization and a headquarters move. Adjusted EBITDA was ($6.7) million, improving from ($14.0) million in the first quarter.
GAAP net loss was $15.7 million, or ($0.18) a share. Non-GAAP net loss was $5.8 million, or ($0.07) a share. Total operating expenses were $71.1 million, or 111% of revenue. Non-GAAP operating expenses were $61.3 million, or 96% of revenue. The year-over-year operating-expense increase was primarily attributable to increased investment in sales personnel and related expenses, as well as increased investments in technology and clinical research.
Cash, cash equivalents and investments totaled $246.8 million as of June 30, 2026.
Non-GAAP gross margin guidance for 2026 was raised to approximately 82% from previous guidance of approximately 81%. Farquhar said record gross margin and improving operating leverage demonstrate the increasing scalability of the model, giving the company greater confidence in long-term, profitable growth. He also said the CCTA market for detecting CAD continues to grow rapidly and remains significantly under-penetrated.
Heartflow said its technology has been adopted by more than 1,800 institutions globally and that it has helped manage care for more than 750,000 patients worldwide.