Heartflow Reports First Quarter 2026 Financial Results and Raises Full Year 2026 Guidance

SAN FRANCISCO, May 14, 2026 (GLOBE NEWSWIRE) -- Heartflow, Inc. (Heartflow) (NASDAQ:HTFL), the leader in AI technology for coronary artery disease (CAD), today reported financial results for the first quarter ended March 31, 2026.

First Quarter 2026 Highlights

• Total revenue of $52.6 million, a 41% increase year-over-year
• Gross margin of 80.2%, non-GAAP gross margin of 80.5%
• Net operating loss of $29.5 million, including a $7.5 million non-cash impairment charge associated with facilities optimization and headquarters relocation to San Francisco. Non-GAAP net operating loss was $15.5 million
  
  

2026 Annual Guidance

• Total revenue of $228 million to $232 million (approximately 29% to 32% growth year-over-year), compared to previous guidance of $218 million to $222 million (approximately 24% to 26% growth year-over-year)
• Non-GAAP gross margin of approximately 81%, compared to previous guidance of 80% to 81%

"Heartflow entered 2026 with unprecedented momentum, expanding the category leadership we established over the last several years," said John Farquhar, President and CEO of Heartflow. "Our AI-driven platform, deeply embedded commercial footprint, and the world's largest database that recently expanded to over 200 million annotated CCTA images combine to create a foundational advantage that grows stronger with every quarter. The growth of our core FFR_CT business remains durable, and adoption of Heartflow Plaque Analysis is ramping ahead of schedule. Most importantly, by helping physicians guide the care of over 650,000 patients worldwide, Heartflow has achieved an unrivaled scale of real-world experience. As the architects of this category, we continue to extend our leadership position, becoming the AI operating system of record for the detection, diagnosis, management, and treatment planning of coronary artery disease."

First Quarter 2026 Financial Results

Total revenue was $52.6 million, a 41% increase year-over-year. U.S. revenue was $48.3 million, a 42% increase year-over-year. International and other revenue was $4.3 million, a 34% increase year-over-year. The year-over-year increase in total global revenue was primarily attributable to an increase in total U.S. FFR_CT volume.

Gross profit was $42.2 million, compared to $27.9 million in the prior year period. Non-GAAP gross profit was $42.3 million, compared to $28.0 million in the prior year period.

Gross margin was 80.2%, compared to 75.1% in the prior year period. Non-GAAP gross margin was 80.5%, compared to 75.3% in the prior year period. The year-over-year gross margin expansion was primarily attributable to an increase in revenue case volume and improved production team productivity driven by AI efficiency initiatives, partially offset by the hiring and training of production team personnel.

Total operating expenses were $71.7 million, or 136% of total revenue, compared to $45.4 million, or 122% of total revenue, in the prior year period. GAAP operating expenses also included a $7.5 million non-cash impairment charge related to the right-of-use asset for our Mountain View, California facility. The Company optimized its facilities footprint and relocated its headquarters to San Francisco. Non-GAAP total operating expenses were $57.8 million, or 110% of total revenue, compared to $43.0 million, or 116% of total revenue, in the prior year period. 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.

Net operating loss was $29.5 million, compared to $17.5 million in the prior year period. Non-GAAP net operating loss was $15.5 million, compared to $15.0 million in the prior year period.

Net loss was $27.4 million, or ($0.32) net loss per share, compared to $32.3 million, or ($5.25) net loss per share, in the prior year period. Non-GAAP net loss was $13.3 million, or ($0.16) non-GAAP net loss per share, compared to $19.2 million, or ($3.11) non-GAAP net loss per share, in the prior year period.

Adjusted EBITDA was ($14.0) million, compared to ($13.6) million in the prior year period.

Cash, cash equivalents and investments totaled $254.9 million as of March 31, 2026.

For additional information regarding non-GAAP financial measures, see "Use of Non-GAAP Measures," "Heartflow GAAP to Non-GAAP Reconciliations" and "Reconciliation of GAAP Net Loss to Adjusted EBITDA" below.

Webcast and Conference Call Details

Heartflow will host a conference call today, May 14, 2026, at 1:30 p.m. PT / 4:30 p.m. ET to discuss its first quarter 2026 financial results. Those interested in listening to the conference call should register online using this link. Once registered, participants will receive dial-in numbers and a unique PIN to join the call. Participants are encouraged to register more than 15 minutes prior to the start of the call. A live and archived webcast of the event will also be available on the "Investor Relations" section of the Heartflow website at https://ir.heartflow.com. The archived version will be available for 12 months following completion of the live call.

About Heartflow's Technology and Research

Heartflow's technology is redefining precision cardiovascular care through clinically-proven AI and the world's largest coronary imaging dataset. Heartflow has been adopted by more than 1,800 institutions globally and continues to strengthen its commercial presence to make this cutting-edge solution more widely available to an increasingly diverse patient population. Backed by American College of Cardiology and American Heart Association (ACC/AHA) guidelines and supported by more than 625 peer-reviewed publications, Heartflow has redefined how clinicians manage care for nearly 650,000 patients worldwide.¹ Key benefits include:

• Unmatched Proprietary data pipeline: Built from the world's largest database of more than 200 million annotated CTA images, Heartflow's data foundation powers advanced AI models that deliver highly accurate, reproducible insights across diverse patient populations.
• Extensive clinical and real-world validation: Heartflow's AI-driven solutions have been validated through clinical evidence in over 200 studies assessing over 365,000 patients. Heartflow is the only AI platform prospectively validated against invasive gold standards and demonstrated through real-world evidence to improve patient outcomes.^2,3,4,5 Proven in real-world practice with reproducibility and accuracy, Heartflow's coronary CTA image acceptance rates exceed 97%.
• Seamless clinical integration via upgraded workflow: Heartflow delivers final quality-reviewed analyses instantly upon order, enabling clinicians to move from diagnosis to decision without delay.
• Quality system, global security and patient-data integrity compliance: Heartflow meets or exceeds leading international standards, including HITRUST, SOC 2 Type 2, ISO 13485, and ISO 27001.

About Heartflow, Inc.

Heartflow is transforming coronary artery disease from the world's leading cause of death into a condition that can be detected early, diagnosed accurately, and managed for life. The Heartflow One platform uses AI to turn coronary CTA images into personalized 3D models of the heart, providing clinically meaningful, actionable insights into plaque location, volume, and composition and its effect on blood flow — all without invasive procedures. Discover how we're shaping the future of cardiovascular care at heartflow.com.

Use of Non-GAAP Measures

To supplement its consolidated financial statements prepared in accordance with U.S. generally accepted accounting principles (GAAP), the Company discloses non-GAAP gross profit and non-GAAP gross margin, non-GAAP total operating expenses, non-GAAP research and development expense, non-GAAP selling, general and administrative expense, non-GAAP net operating loss, non-GAAP net loss, non-GAAP net loss per share, basic and diluted, and Adjusted EBITDA (collectively, the "Non-GAAP Measures") in this press release. As used by the Company, these measures are adjusted to exclude stock-based compensation expense from the comparable GAAP financial measure and, in the case of non-GAAP total operating expenses, non-GAAP loss from operations, non-GAAP net loss and non-GAAP net loss per share, basic and diluted, and an asset impairment charge. Non-GAAP net loss and non-GAAP net loss per share, basic and diluted, are also adjusted for change in fair value of common stock warrant liability, change in fair value of derivative liability, and asset impairment charge. In addition, Adjusted EBITDA is calculated by adding back to net loss or excluding, as appropriate, interest income and expense, provision for income taxes, and charges for depreciation and amortization and is further adjusted by adding back in or excluding, stock-based compensation and, as appropriate, other income and expense items that are not reflective of the Company's underlying continuing operating performance. Reconciliations of the Non-GAAP Measures to their most directly comparable GAAP financial measures are provided in the financial statement tables included at the end of this press release, and investors are encouraged to review the reconciliations. The Company believes the presentation of the Non-GAAP Measures, when shown in conjunction with the corresponding GAAP measures, provides useful information to investors as it provides visibility to the Company's underlying continuing operating performance from period to period by excluding the impact of stock-based compensation and certain other items that are not reflective of the Company's ongoing operations. Because of the variety of equity awards used by companies, the varying methodologies for determining stock-based compensation expense, the subjective assumptions used in those determinations, and the volatility in valuations that can be driven by market conditions outside the Company's control, we believe excluding stock-based compensation expense enhances the ability of management and investors to understand and assess the underlying performance of our business over time and compare it against our peers, a majority of whom also exclude stock-based compensation expense from their non-GAAP results. With respect to the presentation of Adjusted EBITDA, the Company believes it is a useful measure to evaluate the Company's operating performance and it is used by the Company to evaluate ongoing operations and for planning and forecasting purposes. Adjusted EBITDA is also a measure frequently used by analysts, investors and other interested parties to evaluate companies in our same industry.

The Company's definition of the Non-GAAP Measures may differ from similarly titled measures used by others. The Non-GAAP Measures should be considered only as a supplement to, and not as a substitute for, or superior to, their most directly comparable GAAP financial measures. Because the Non-GAAP Measures exclude the effect of items that increase or decrease the Company's reported results of operations, management strongly encourages investors to review the reconciliations to the most comparable GAAP financial measures at the end of this press release and, when they become available, the Company's consolidated financial statements and publicly filed Securities and Exchange Commission ("SEC") reports in their entirety.

The Company is not able to provide a reconciliation without unreasonable efforts of its forward-looking guidance related to non-GAAP gross margin to the most directly comparable GAAP financial measure due to the unknown effect of stock-based compensation that is material to the comparable GAAP financial measure.

Forward-Looking Statements

This press release contains express or implied forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. All statements other than statements of historical facts contained in this press release, including statements regarding our strategy, expected market growth and financial guidance, are forward-looking statements. These forward-looking statements are based on management's current expectations and are subject to risks and uncertainties that may cause actual results to differ materially from those expressed or implied in the forward-looking statements, including, but not limited to: we may not be able to achieve or sustain profitability; our dependence on the success of our one product, Heartflow FFR_CT Analysis; healthcare providers may be unwilling to change their standard practice regarding the evaluation of coronary artery disease; adoption of the Heartflow Platform by healthcare providers may be negatively impacted if third-party payors, including government payors, do not cover or provide adequate reimbursement; the concentration of our customer base; the significant competition we face in an environment of rapid technological change; the commercialization of Heartflow Plaque Analysis is nascent; risks associated with our use and development of AI models; risks related to failing to properly manage our future growth; disruption by catastrophic events; risks associated with our dependence on our information technology systems; security breaches that we cannot anticipate or successfully defend; extensive regulatory requirements we face to bring our products to market; and third parties could develop and commercialize technology and products similar or identical to ours. For a more extensive description of these and other risks and uncertainties that could materially affect our results, you should read our filings with the SEC, including our Annual Report on Form 10-K and Quarterly Reports on Form 10-Q, as such filings may be amended, supplemented or superseded from time to time by other reports Heartflow files with the SEC. You should not place undue reliance on the forward-looking statements in this press release, which speak only as of the date hereof, and we undertake no obligation to update the forward-looking statements to reflect events or circumstances after the date of this press release or to reflect new information or the occurrence of unanticipated events, except as required by law.

Investor Contact

Nick Laudico

nlaudico@heartflow.com

Media Contact

Elliot Levy

elevy@heartflow.com

HEARTFLOW, INC.
Consolidated Statements of Operations Data
(unaudited, in thousands, except share and per share data)
		Three Months Ended
		March 31,
			2026				2025
Revenue		$	52,587			$	37,205
Cost of revenue			10,423				9,264
Gross profit			42,164				27,941
Operating Expenses:
Research and development			21,620				13,924
Selling, general and administrative			42,566				31,519
Asset impairment charge			7,482				-
Total operating expenses			71,668				45,443
Loss from operations			(29,504	)			(17,502	)
Interest income			2,464				543
Interest expense			(3	)			(5,093	)
Change in fair value of common stock warrant liability			-				(1,606	)
Change in fair value of derivative liability			-				(9,045	)
Other income (expense), net			(314	)			358
Loss before provision for income taxes			(27,357	)			(32,345	)
Provision for income taxes			(23	)			-
Net loss		$	(27,380	)		$	(32,345	)
Comprehensive loss:
Net loss		$	(27,380	)		$	(32,345	)
Other comprehensive loss:
Foreign currency translation gain (loss)			262				(236	)
Unrealized loss on investments, net			(522	)			-
Total other comprehensive loss			(260	)			(236	)
Total comprehensive loss		$	(27,640	)		$	(32,581	)
Net loss per share, basic and diluted		$	(0.32	)		$	(5.25	)
Weighted-average shares used to compute net loss per share, basic and diluted			85,639,675				6,164,617

HEARTFLOW, INC. Consolidated Balance Sheets Data (unaudited, in thousands, except par value)
	March 31,				December 31,
	2026				2025
Assets
Current assets
Cash and cash equivalents	$	19,671			$	44,776
Short-term investments		138,645				132,010
Accounts receivable, net		35,527				29,343
Prepaid expenses and other current assets		17,987				14,075
Total current assets		211,830				220,204
Long-term investments		96,582				103,365
Property and equipment, net		9,829				8,587
Operating lease right-of-use assets		14,407				17,488
Restricted cash, non-current		4,702				4,709
Other non-current assets		6,675				5,099
Total assets	$	344,025			$	359,452
Liabilities and stockholders' equity
Current liabilities
Accounts payable	$	5,750			$	3,169
Accrued expenses and other current liabilities		25,886				33,279
Operating lease liabilities, current portion		6,382				5,922
Total current liabilities		38,018				42,370
Operating lease liabilities, non-current portion		19,967				16,132
Other non-current liabilities		322				303
Total liabilities		58,307				58,805
Stockholders' equity
Preferred stock, $0.001 par value		-				-
Common stock, $0.001 par value		86				85
Additional paid-in capital		1,401,447				1,388,737
Accumulated other comprehensive loss		(685	)			(425	)
Accumulated deficit		(1,115,130	)			(1,087,750	)
Total stockholders' equity		285,718				300,647
Total liabilities and stockholders' equity	$	344,025			$	359,452

Heartflow, Inc. GAAP to Non-GAAP Reconciliations (unaudited, in thousands except for per share amounts and percentage data)
			Three Months Ended March 31, 2026														Three Months Ended March 31, 2025
			GAAP				Adjustments						Non-GAAP				GAAP				Adjustments						Non-GAAP
Gross profit		$	42,164			$	166			(a)		$	42,330			$	27,941			$	57			(a)		$	27,998
Gross margin			80.2	%			0.3	%					80.5	%			75.1	%			0.2	%					75.3	%
Operating Expenses:
Research and development		$	21,620			$	(2,137	)		(a)		$	19,483			$	13,924			$	(547	)		(a)		$	13,377
Selling, general and administrative		$	42,566			$	(4,251	)		(a)		$	38,315			$	31,519			$	(1,888	)		(a)		$	29,631
Asset impairment charge		$	7,482			$	(7,482	)				$	-			$	-			$	-					$	-
Total operating expenses		$	71,668			$	(13,870	)				$	57,798			$	45,443			$	(2,435	)				$	43,008
Loss from operations		$	(29,504	)		$	14,036					$	(15,468	)		$	(17,502	)		$	2,492					$	(15,010	)
Net loss		$	(27,380	)		$	14,036			(b)		$	(13,344	)		$	(32,345	)		$	13,143			(c)		$	(19,202	)
Net loss per share, basic and diluted		$	(0.32	)		$	0.16					$	(0.16	)		$	(5.25	)		$	2.14					$	(3.11	)
(a) Represents adjustments related to stock-based compensation expense
(b) Represents adjustments for: (i) stock-based compensation expense of $6.5 million; and (ii) asset impairment charge of $7.5 million
(c) Represents adjustments for: (i) stock-based compensation expense of $2.5 million; (ii) change in fair value of common stock warrant liability of $1.6 million; and (iii) change in fair value of derivative liability of $9.0 million

Heartflow, Inc. Reconciliation of GAAP Net Loss to Adjusted EBITDA (unaudited, in thousands)
		Three Months Ended
		March 31,
		2026				2025
GAAP net loss		$	(27,380	)		$	(32,345	)
Non-GAAP adjustments:
Interest (income) expense, net			(2,461	)			4,550
Asset impairment charge			7,482				-
Change in fair value of common stock warrant liability			-				1,606
Change in fair value of derivative liability			-				9,045
Other (income) expense, net			314				(358	)
Provision for income taxes			23				-
Depreciation and amortization			1,423				1,372
Stock-based compensation expense			6,554				2,492
Adjusted EBITDA		$	(14,045	)		$	(13,638	)

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¹ Gulati, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation & Diagnosis of Chest Pain. J Am Coll Cardiol

² Narula, et al. E HJ CVI 2024

³ Danad, et al. JAMA Cardiol 2017

⁴ Fairbairn et al. Coronary CT Angiography Plaque as a Predictor of Death, Cardiovascular Death and Myocardial Infarction. Presented at AHA 2025. (Real-world study with n=7,899 patients, higher TPV results in increased cardiovascular death and MI)

⁵ Madsen KT, et al. ADVANCE-DK 7-year. Presented at TCT Scientific Sessions 2024 (n=900 patients determined a 2.5x increase in cardiovascular events or deaths at 7 years)