Heartflow NASDAQ: HTFL reported second-quarter revenue of $64.1 million, up 48% from a year earlier, as growth in its Plaque Analysis offering, durable FFR-CT utilization and continued expansion of the coronary CT angiography, or CCTA, market supported results.
U.S. revenue rose 51% to $59.6 million, including $7.8 million from plaque revenue, while revenue outside the U.S. and other revenue totaled $4.5 million. Global revenue cases increased 74% to 84,491 during the quarter ended June 30.
“Our year-over-year revenue growth accelerated for the second consecutive quarter, and we finished ahead of our expectations,” President and CEO John Farquhar said. He cited plaque adoption, FFR-CT utilization at existing accounts, new-account additions and growth in the underlying CCTA market as key drivers.
Raised 2026 outlook
Following the second-quarter performance, Heartflow raised its full-year revenue forecast to $246 million to $250 million, representing 40% to 42% year-over-year growth. The company also increased its 2026 plaque revenue outlook to $29 million to $31 million and now expects approximately 1,250 plaque-activated accounts by year-end.
Chief Financial Officer Vikram Verghese said plaque revenue exceeded internal expectations, while results were broad-based across both plaque and FFR-CT. He said the company saw favorable seasonal demand in the second quarter, continued utilization growth at existing sites and contributions from recently added accounts.
Heartflow said new accounts generally take about a year to approach full FFR-CT utilization. The company estimates FFR-CT is applicable to approximately 33% of CCTA scans, while plaque analysis is applicable to about 60% of scans.
Farquhar said plaque activations were ahead of plan and that ordering-physician metrics, including both new and repeat orders, reached record levels. He added that the company had roughly 78% coverage for plaque.
Margins and path to profitability
Non-GAAP gross margin reached 83.3% in the quarter, compared with 75.6% a year earlier. The expansion reflected volume leverage, production efficiencies, a higher mix of plaque revenue and progress in AI-enabled automation, according to Verghese.
The company raised its full-year non-GAAP gross-margin outlook to approximately 82%, up 500 basis points year over year. It continues to target a midterm non-GAAP gross margin of 85%, with autonomous processing expected to become a more significant margin driver in 2027.
Second-quarter non-GAAP operating expenses were 96% of revenue, down from 102% a year earlier. Non-GAAP operating loss narrowed to $7.9 million from $11.5 million, while non-GAAP net loss narrowed to $5.8 million, or $0.07 per share, from $17.6 million, or $2.79 per share.
On a GAAP basis, net loss was $15.7 million, or $0.18 per share. Heartflow ended the quarter with $246.8 million in cash equivalents and investments and said it remained on track to achieve cash-flow profitability by mid-2028.
Product launches and clinical evidence
At the Society of Cardiovascular Computed Tomography meeting in July, Heartflow launched Plaque Staging, a tool designed to classify disease burden into four stages to help physicians assess patient risk and guide medical management. Farquhar said the tool was validated in more than 23,000 patients with up to 16 years of follow-up.
The company also said PCI Navigator, launched earlier in 2026, is gaining traction and remains on track for a broader rollout in 2027. The product combines lesion-specific FFR-CT and plaque information to help interventional cardiologists plan procedures. Heartflow does not currently charge for PCI Navigator and does not plan to seek reimbursement for it, Farquhar said, describing it as a platform differentiator intended to support adoption of a CT-first pathway.
Heartflow presented eight new data sets involving more than 36,000 patients at SCCT. Among the findings cited by the company, a blinded prospective study published in the Journal of the American College of Cardiology showed minimal variability in repeat scans using Heartflow Plaque Analysis. Separately, an analysis of nearly 12,000 symptomatic patients in the DECIDE registry found that Plaque Staging reclassified half of patients with a zero calcium score into a higher-risk category by identifying non-calcified plaque.
Asymptomatic-market plans
Heartflow said it plans to expand plaque analysis into high-risk asymptomatic populations, which it estimates could increase its U.S. total addressable market by roughly $6 billion to approximately $11 billion.
- A trial involving patients with coronary artery calcium is scheduled to begin enrollment in the fourth quarter of 2026.
- A study involving patients with prior myocardial infarction or PCI is also expected to begin enrollment in the fourth quarter.
- A trial involving patients with prior plaque is planned to begin enrollment in the first quarter of 2027.
Farquhar said the studies would use the company’s existing technology and would evaluate changes in physician management and outcomes measured by changes in LDL cholesterol and soft plaque. He said Heartflow does not expect to need additional FDA clearance for these uses and aims to enter the markets with reimbursed technology before 2030.
The company also said it was selected as the exclusive plaque provider for the PRE-EMPT Study, an NIH-funded 1,500-patient study examining whether direct measurement of coronary disease can improve prevention among younger asymptomatic patients.
About Heartflow (NASDAQ:HTFL)
HeartFlow, Inc NASDAQ: HTFL is a medical technology company that develops non-invasive diagnostic solutions for coronary artery disease. The company's core offering translates coronary CT angiography (CTA) data into a patient-specific, three-dimensional physiological model of the coronary arteries. Using advanced image processing and computational modeling, HeartFlow's analysis estimates fractional flow reserve (FFR) values throughout the coronary tree to identify ischemia-producing lesions without the need for invasive pressure-wire measurements.
HeartFlow's cloud-based service integrates with clinical workflows: clinicians submit coronary CTA images and receive a detailed, color-coded 3D map and report that highlights lesion-specific FFR values and physiological impact.
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