Heartflow, Inc. Common Stock

HeartFlow reported second-quarter 2026 revenue of $64.1 million, up 48% year over year, with U.S. revenue up 51% to $59.6 million and OUS/other revenue of $4.5 million. Non-GAAP gross margin was 83.3% versus 75.6% in Q2 2025, and non-GAAP net loss improved to $5.8 million, or $0.07 per share, from $17.6 million, or $2.79 per share, a year ago; GAAP net loss was $15.7 million, or $0.18 per share. For the full year, management raised revenue guidance to $246 million-$250 million, Plaque revenue guidance to $29 million-$31 million, Plaque-activated accounts to approximately 1,250, and non-GAAP gross margin to approximately 82%.

John Farquhar called Q2 an outstanding quarter and said revenue growth accelerated for a second straight quarter, driven by category leadership, a growing CCTA market, and strong Plaque and FFRCT performance. He emphasized that Plaque is winning at the point of sale because of accuracy and reproducibility, while FFRCT remains differentiated through lesion-specific values and published prospective validation. His tone was highly confident, highlighting innovation launches like Plaque Staging and PCI Navigator and a longer-term push into high-risk asymptomatic populations.

Vikram Verghese highlighted 48% revenue growth, 770 basis points of gross margin expansion, and a 600 basis point improvement in operating expenses as a percentage of revenue. He said gross margin reached 83.3% versus 75.6% a year ago, helped by volume leverage, production efficiency, increased Plaque revenue, and AI-enabled automation. He also noted SG&A of $37.8 million, R&D of $23.5 million, non-GAAP operating loss of $7.9 million, cash and investments of $246.8 million, and reiterated the company’s path to cash flow profitability by mid-2028.

Analysts pressed on what specifically is driving Plaque adoption, and management pointed to stronger activations, record ordering physicians, broader physician utilization, and coverage around 78%. Questions on the second-half guidance and revenue phasing were answered with management saying the forecast is intentionally conservative and assumes steady sequential growth with room to outperform, while seasonality is more relevant to FFRCT. Management also said Plaque ASPs benefited from contractual step-ups and mix in Q2, with more meaningful pricing increases expected in early 2027.