Second Quarter 2026
Filed Aug 13, 2026Heartflow Reports Second Quarter 2026 Financial Results and Raises Full Year 2026 Guidance
Total revenue increased 48% year-over-year to $64.1 million, gross margin expanded to 83.0%, non-GAAP net operating loss improved to $7.9 million, and the Company raised full-year 2026 revenue and non-GAAP gross-margin guidance.
Key metrics
as reported| Metric | Value | q/q | y/y |
|---|---|---|---|
| Total revenueGAAP | $64.1 million | – | 48% |
| Cost of revenueGAAP | $ 10,892 (in thousands) | – | – |
| Gross profitGAAP | $53.2 million | – | – |
| Gross marginGAAP | 83.0% | – | – |
| Gross profitnon-GAAP | $53.4 million | – | – |
| Gross marginnon-GAAP | 83.3% | – | – |
| Research and development expenseGAAP | $ 26,261 (in thousands) | – | – |
| Research and development expensenon-GAAP | $ 23,529 (in thousands) | – | – |
| Selling, general and administrative expenseGAAP | $ 44,829 (in thousands) | – | – |
| Selling, general and administrative expensenon-GAAP | $ 37,758 (in thousands) | – | – |
| Total operating expensesGAAP | $71.1 million, or 111% of total revenue | – | – |
| Total operating expensesnon-GAAP | $61.3 million, or 96% of total revenue | – | – |
| Net operating lossGAAP | $17.9 million | – | – |
| Net operating lossnon-GAAP | $7.9 million | – | – |
| Interest incomeGAAP | $ 2,305 (in thousands) | – | – |
| Interest expenseGAAP | $ - (in thousands) | – | – |
| Net lossGAAP | $15.7 million | – | – |
| Net loss per shareGAAP | ($0.18) net loss per share | – | – |
| Net lossnon-GAAP | $5.8 million | – | – |
| Net loss per sharenon-GAAP | ($0.07) non-GAAP net loss per share | – | – |
| Adjusted EBITDAnon-GAAP | ($6.7) million | – | – |
| Six months ended June 30 revenueGAAP | $ 116,669 (in thousands) | – | – |
| Six months ended June 30 gross profitGAAP | $ 95,354 (in thousands) | – | – |
| Six months ended June 30 gross marginGAAP | 81.7% | – | – |
| Six months ended June 30 net lossGAAP | $ 43,123 (in thousands) | – | – |
| Six months ended June 30 non-GAAP net lossnon-GAAP | $ 18,694 (in thousands) | – | – |
| Six months ended June 30 Adjusted EBITDAnon-GAAP | $ (20,332) (in thousands) | – | – |
Segments
| Segment | Revenue | q/q | y/y |
|---|---|---|---|
| U.S. revenueThe year-over-year increase in total global revenue was primarily attributable to an increase in total U.S. FFR CT revenue case volume and an increase in total U.S. Plaque revenue case volume. | $59.6 million | – | 51% |
| International and other revenueThe year-over-year increase in total global revenue was primarily attributable to an increase in total U.S. FFR CT revenue case volume and an increase in total U.S. Plaque revenue case volume. | $4.5 million | – | 12% |
2026 Annual Guidance outlook
- Revenue$246 million to $250 million
- Gross marginNon-GAAP gross margin of approximately 82%
- Noteapproximately 40% to 42% growth year-over-year
What drove it
- The year-over-year increase in total global revenue was primarily attributable to an increase in total U.S. FFR CT revenue case volume and an increase in total U.S. Plaque revenue case volume.
- The year-over-year gross margin expansion was primarily attributable to an increase in total revenue case volume, an increase in total U.S. Plaque revenue case volume, and improved production team productivity driven by AI efficiency initiatives, partially offset by the hiring and training of production team personnel.
- 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.
Concerns
- GAAP net operating loss was $17.9 million, compared to $13.7 million in the prior year period.
- Total operating expenses were $71.1 million, or 111% of total revenue, compared to $46.5 million, or 107% of total revenue, in the prior year period.
- The Company reported a $ 7,482 (in thousands) asset impairment charge for the six months ended June 30, 2026.
- Commercialization of Heartflow Plaque Analysis is nascent.
What to watch
- Execution against 2026 annual total revenue guidance of $246 million to $250 million.
- Delivery of non-GAAP gross margin of approximately 82% for 2026.
- U.S. FFR CT revenue case volume and U.S. Plaque revenue case volume.
- Sales personnel, technology and clinical-research investments and their effect on operating expenses.
- Progress toward profitability, given the reported GAAP net loss and non-GAAP net loss.
Balance sheet and cash flow
- Cash, cash equivalents and investments totaled $246.8 million as of June 30, 2026.
- Cash and cash equivalents were $ 34,362 (in thousands) as of June 30, 2026, compared to $ 44,776 (in thousands) as of December 31, 2025.
- Short-term investments were $ 128,189 (in thousands) as of June 30, 2026, compared to $ 132,010 (in thousands) as of December 31, 2025.
- Long-term investments were $ 84,289 (in thousands) as of June 30, 2026, compared to $ 103,365 (in thousands) as of December 31, 2025.
- Restricted cash, non-current was $ 4,702 (in thousands) as of June 30, 2026, compared to $ 4,709 (in thousands) as of December 31, 2025.
- Accounts receivable, net was $ 42,761 (in thousands) as of June 30, 2026, compared to $ 29,343 (in thousands) as of December 31, 2025.
- Total assets were $ 344,463 (in thousands) as of June 30, 2026, compared to $ 359,452 (in thousands) as of December 31, 2025.
- Total liabilities were $ 64,736 (in thousands) as of June 30, 2026, compared to $ 58,805 (in thousands) as of December 31, 2025.
- Total stockholders’ equity was $ 279,727 (in thousands) as of June 30, 2026, compared to $ 300,647 (in thousands) as of December 31, 2025.
Analysis
Heartflow delivered 48% year-over-year total revenue growth to $64.1 million in the second quarter. U.S. revenue increased 51% year-over-year to $59.6 million, while international and other revenue increased 12% to $4.5 million. The Company attributed global growth to higher total U.S. FFR CT revenue case volume and higher total U.S. Plaque revenue case volume, identifying Plaque as an emerging second growth engine alongside FFR CT.
Gross margin expanded to 83.0% from 75.5%, and non-GAAP gross margin expanded to 83.3% from 75.6%. Management attributed the expansion to higher total revenue case volume, higher U.S. Plaque revenue case volume, and improved production-team productivity from AI efficiency initiatives. Hiring and training of production-team personnel partially offset those gains.
Operating investment remained substantial. GAAP total operating expenses were $71.1 million, or 111% of total revenue, versus $46.5 million, or 107% of total revenue, in the prior-year period. The Company cited sales personnel and related costs, technology investment, and clinical research as the principal expense drivers. GAAP net operating loss was $17.9 million versus $13.7 million, while non-GAAP net operating loss improved to $7.9 million from $11.5 million. Adjusted EBITDA improved to ($6.7) million from ($10.1) million.
Liquidity was $246.8 million of cash, cash equivalents and investments as of June 30, 2026. The Company raised 2026 annual revenue guidance to $246 million to $250 million from previous guidance of $228 million to $232 million and raised its non-GAAP gross-margin outlook to approximately 82% from approximately 81%. The release does not provide prior-quarter operating results or cash-flow metrics, so the quarter-over-quarter trajectory of revenue, expenses, and cash usage cannot be assessed from this document.
Management, verbatim
The second quarter reflects the growing strength of Heartflow's category leadership and unique AI technology platform for identifying, diagnosing, managing and treating coronary artery disease.
John Farquhar, President and CEO of Heartflow
Our FFR CT business remains strong and durable, while Plaque is rapidly emerging as a meaningful second growth engine — helping us win new accounts, deepen physician utilization and expand the value of the Heartflow platform for our customers.
John Farquhar, President and CEO of Heartflow
Not in the filing
stated, not guessed- Prior-quarter revenue, segment revenue, gross margin, operating expenses, operating income or loss, net income or loss, EPS, and Adjusted EBITDA comparisons
- Operating cash flow
- Free cash flow
- Capital expenditures
- Debt balance
- Share repurchases
- Dividend declaration or payment
- Forward operating-expense guidance
- Forward tax-rate guidance
- GAAP gross-margin guidance
- Reconciliation of forward non-GAAP gross-margin guidance to the most directly comparable GAAP financial measure
AlphaAI analysis generated from the company’s SEC earnings filing (Form 8-K Item 2.02, or Form 6-K for a foreign private issuer). Every figure was cross-checked against the filing text; consensus estimates, price targets and share-price reactions are not shown because they are not in the filing. AI-generated research, not investment advice.