Fourth Quarter 2025 Highlights
- Total revenue of
$49.1 million , a 40% increase year-over-year - Gross margin of 79.5%, non-GAAP gross margin of 79.9%
- Net operating loss of
$17.8 million , non-GAAP net operating loss of$12.5 million U.S. installed base of 1,465 accounts as ofDecember 31, 2025 U.S. Plaque installed base of 489 accounts as ofDecember 31, 2025 - Aetna began coverage of Heartflow Plaque Analysis, bringing total
U.S. covered lives for Plaque to approximately 75%
2026 Annual Guidance
- Total revenue of
$218 million to$222 million (approximately 24% to 26% growth year-over-year) - Non-GAAP gross margin of 80% to 81%
“Our strong fourth quarter performance concluded a record year for Heartflow,” said
Fourth Quarter 2025 Financial Results
Total revenue was
Gross profit was
Gross margin was 79.5%, compared to 75.0% in the prior year period. Non-GAAP gross margin was 79.9%, 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
Net operating loss was
Net loss was
Non-GAAP net loss was
Adjusted EBITDA was
Full Year 2025 Financial Results
Total revenue was
Gross profit was
Gross margin was 76.8%, compared to 75.1% in the prior year period. Non-GAAP gross margin was 77.0%, 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
Net operating loss was
Net loss was
Non-GAAP net loss was
Adjusted EBITDA was
Cash, cash equivalents and investments totaled
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,
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
- Proprietary data pipeline: Built from more than 160 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. 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 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
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
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 FFRCT 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 commercial 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
Investor Contact
nlaudico@heartflow.com
Media Contact
elevy@heartflow.com
| Consolidated Statements of Operations | ||||||||||||||||
| (unaudited, in thousands, except share and per share data) | ||||||||||||||||
| Three Months Ended | Year Ended | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| Revenue | $ | 49,130 | $ | 34,977 | $ | 176,034 | $ | 125,808 | ||||||||
| Cost of revenue | 10,067 | 8,727 | 40,837 | 31,359 | ||||||||||||
| Gross profit | 39,063 | 26,250 | 135,197 | 94,449 | ||||||||||||
| Operating Expenses: | ||||||||||||||||
| Research and development | 18,665 | 12,279 | 64,918 | 43,517 | ||||||||||||
| Selling, general and administrative | 38,148 | 30,029 | 134,345 | 112,154 | ||||||||||||
| Total operating expenses | 56,813 | 42,308 | 199,263 | 155,671 | ||||||||||||
| Loss from operations | (17,750 | ) | (16,058 | ) | (64,066 | ) | (61,222 | ) | ||||||||
| Interest income | 2,635 | 592 | 5,538 | 4,066 | ||||||||||||
| Interest expense | (8 | ) | (5,152 | ) | (15,173 | ) | (22,768 | ) | ||||||||
| Change in fair value of common stock warrant liability | (9,308 | ) | (11,905 | ) | (43,894 | ) | (16,395 | ) | ||||||||
| Change in fair value of derivative liability | - | - | 7,311 | (222 | ) | |||||||||||
| Loss on extinguishment of debt | - | - | (6,360 | ) | - | |||||||||||
| Other income (expense), net | (129 | ) | (447 | ) | (223 | ) | 168 | |||||||||
| Loss before provision for income taxes | (24,560 | ) | (32,970 | ) | (116,867 | ) | (96,373 | ) | ||||||||
| (Provision for) benefit from income taxes | 165 | (5 | ) | 76 | (53 | ) | ||||||||||
| Net loss | $ | (24,395 | ) | $ | (32,975 | ) | $ | (116,791 | ) | $ | (96,426 | ) | ||||
| Comprehensive loss: | ||||||||||||||||
| Net loss | $ | (24,395 | ) | $ | (32,975 | ) | $ | (116,791 | ) | $ | (96,426 | ) | ||||
| Other comprehensive income (loss): | ||||||||||||||||
| Foreign currency translation gain (loss) | (69 | ) | 233 | 191 | (271 | ) | ||||||||||
| Unrealized gain on investments, net | 156 | - | 156 | - | ||||||||||||
| Total other comprehensive income (loss) | 87 | 233 | 347 | (271 | ) | |||||||||||
| Total comprehensive loss | $ | (24,308 | ) | $ | (32,742 | ) | $ | (116,444 | ) | $ | (96,697 | ) | ||||
| Net loss per share, basic and diluted | $ | (0.29 | ) | $ | (5.59 | ) | $ | (3.17 | ) | $ | (17.98 | ) | ||||
| Weighted-average shares used to compute net loss per share, basic and diluted | 84,828,694 | 5,894,840 | 36,853,867 | 5,363,435 | ||||||||||||
| Consolidated Balance Sheets | ||||||||
| (unaudited, in thousands) | ||||||||
| 2025 | 2024 | |||||||
| Assets | ||||||||
| Current assets | ||||||||
| Cash and cash equivalents | $ | 44,776 | $ | 51,367 | ||||
| Short-term investments | 132,010 | - | ||||||
| Accounts receivable, net | 29,343 | 24,639 | ||||||
| Restricted cash, current | - | 150 | ||||||
| Prepaid expenses and other current assets | 14,075 | 6,132 | ||||||
| Total current assets | 220,204 | 82,288 | ||||||
| Long-term investments | 103,365 | - | ||||||
| Property and equipment, net | 8,587 | 8,920 | ||||||
| Operating lease right-of-use assets | 17,488 | 18,805 | ||||||
| Restricted cash, non-current | 4,709 | 4,325 | ||||||
| Other non-current assets | 5,099 | 4,366 | ||||||
| Total assets | $ | 359,452 | $ | 118,704 | ||||
| Liabilities, redeemable convertible preferred stock and stockholders’ equity (deficit) | ||||||||
| Current liabilities | ||||||||
| Accounts payable | $ | 3,169 | $ | 2,870 | ||||
| Accrued expenses and other current liabilities | 33,279 | 25,319 | ||||||
| Operating lease liabilities, current portion | 5,922 | 5,416 | ||||||
| Total current liabilities | 42,370 | 33,605 | ||||||
| Term loan | - | 136,431 | ||||||
| Common stock warrant liability | - | 20,835 | ||||||
| Operating lease liabilities, non-current portion | 16,132 | 18,537 | ||||||
| Other non-current liabilities | 303 | 214 | ||||||
| Total liabilities | 58,805 | 209,622 | ||||||
| Redeemable convertible preferred stock issuable in series, | - | 768,566 | ||||||
| Stockholders’ equity (deficit) | ||||||||
| Preferred stock, | - | - | ||||||
| Common stock, | 85 | 6 | ||||||
| Additional paid-in capital | 1,388,737 | 112,241 | ||||||
| Accumulated other comprehensive income | (425 | ) | (772 | ) | ||||
| Accumulated deficit | (1,087,750 | ) | (970,959 | ) | ||||
| Total stockholders’ equity (deficit) | 300,647 | (859,484 | ) | |||||
| Total liabilities, redeemable convertible preferred stock and stockholders’ equity (deficit) | $ | 359,452 | $ | 118,704 | ||||
| GAAP to Non-GAAP Reconciliations | ||||||||||||||||||||||||
| (unaudited, in thousands except per share amounts and percentage data) | ||||||||||||||||||||||||
| Three Months Ended | Three Months Ended | |||||||||||||||||||||||
| GAAP | Adjustments | Non-GAAP | GAAP | Adjustments | Non-GAAP | |||||||||||||||||||
| Gross profit | $ | 39,063 | $ | 184 | (a) | $ | 39,247 | $ | 26,250 | $ | 76 | (a) | $ | 26,326 | ||||||||||
| Gross margin | 79.5 | % | 0.4 | % | 79.9 | % | 75.0 | % | 0.2 | % | 75.3 | % | ||||||||||||
| Operating Expenses: | ||||||||||||||||||||||||
| Research and development | $ | 18,665 | $ | (1,547 | ) | (a) | $ | 17,118 | $ | 12,279 | $ | (585 | ) | (a) | $ | 11,694 | ||||||||
| Selling, general and administrative | $ | 38,148 | $ | (3,529 | ) | (a) | $ | 34,619 | $ | 30,029 | $ | (1,853 | ) | (a) | $ | 28,176 | ||||||||
| Total operating expenses | $ | 56,813 | $ | (5,076 | ) | $ | 51,737 | $ | 42,308 | $ | (2,438 | ) | $ | 39,870 | ||||||||||
| Loss from operations | $ | (17,750 | ) | $ | 5,260 | $ | (12,490 | ) | $ | (16,058 | ) | $ | 2,514 | $ | (13,544 | ) | ||||||||
| Net loss | $ | (24,395 | ) | $ | 14,568 | (b) | $ | (9,827 | ) | $ | (32,975 | ) | $ | 14,419 | (c) | $ | (18,556 | ) | ||||||
| Net loss per share, basic and diluted | $ | (0.29 | ) | $ | 0.17 | $ | (0.12 | ) | $ | (5.59 | ) | $ | 2.44 | $ | (3.15 | ) | ||||||||
| (a) Represents adjustments related to stock-based compensation expense | ||||||||||||||||||||||||
| (b) Represents adjustments for: (i) stock-based compensation expense of | ||||||||||||||||||||||||
| (c) Represents adjustments for: (i) stock-based compensation expense of | ||||||||||||||||||||||||
| GAAP to Non-GAAP Reconciliations | ||||||||||||||||||||||||
| (unaudited, in thousands except per share amounts and percentage data) | ||||||||||||||||||||||||
| Year Ended | Year Ended | |||||||||||||||||||||||
| GAAP | Adjustments | Non-GAAP | GAAP | Adjustments | Non-GAAP | |||||||||||||||||||
| Gross profit | $ | 135,197 | $ | 413 | (a) | $ | 135,610 | $ | 94,449 | $ | 307 | (a) | $ | 94,756 | ||||||||||
| Gross margin | 76.8 | % | 0.2 | % | 77.0 | % | 75.1 | % | 0.2 | % | 75.3 | % | ||||||||||||
| Operating Expenses: | ||||||||||||||||||||||||
| Research and development | $ | 64,918 | $ | (3,434 | ) | (a) | $ | 61,484 | $ | 43,517 | $ | (2,151 | ) | (a) | $ | 41,366 | ||||||||
| Selling, general and administrative | $ | 134,345 | $ | (10,118 | ) | (a) | $ | 124,227 | $ | 112,154 | $ | (7,755 | ) | (a) | $ | 104,399 | ||||||||
| Total operating expenses | $ | 199,263 | $ | (13,552 | ) | $ | 185,711 | $ | 155,671 | $ | (9,906 | ) | $ | 145,765 | ||||||||||
| Loss from operations | $ | (64,066 | ) | $ | 13,965 | $ | (50,101 | ) | $ | (61,222 | ) | $ | 10,213 | $ | (51,009 | ) | ||||||||
| Net loss | $ | (116,791 | ) | $ | 56,908 | (b) | $ | (59,883 | ) | $ | (96,426 | ) | $ | 26,830 | (c) | $ | (69,596 | ) | ||||||
| Net loss per share, basic and diluted | $ | (3.17 | ) | $ | 1.55 | $ | (1.62 | ) | $ | (17.98 | ) | $ | 5.00 | $ | (12.98 | ) | ||||||||
| (a) Represents adjustments related to stock-based compensation expense | ||||||||||||||||||||||||
| (b) Represents adjustments for: (i) stock-based compensation expense of | ||||||||||||||||||||||||
| (c) Represents adjustments for: (i) stock-based compensation expense of | ||||||||||||||||||||||||
| Reconciliation of GAAP Net Loss to Adjusted EBITDA | ||||||||||||||||
| (unaudited, in thousands) | ||||||||||||||||
| Three Months Ended | Year Ended | |||||||||||||||
| 2025 | 2024 | 2025 | 2024 | |||||||||||||
| GAAP net loss | $ | (24,395 | ) | $ | (32,975 | ) | $ | (116,791 | ) | $ | (96,426 | ) | ||||
| Non-GAAP adjustments: | ||||||||||||||||
| Interest (income) expense, net | (2,627 | ) | 4,560 | 9,635 | 18,702 | |||||||||||
| Change in fair value of common stock warrant liability | 9,308 | 11,905 | 43,894 | 16,395 | ||||||||||||
| Change in fair value of derivative liability | - | - | (7,311 | ) | 222 | |||||||||||
| Loss on extinguishment of debt | - | - | 6,360 | - | ||||||||||||
| Other (income) expense, net | 129 | 447 | 223 | (168 | ) | |||||||||||
| Provision for (benefit from) income taxes | (165 | ) | 5 | (76 | ) | 53 | ||||||||||
| Depreciation and amortization | 1,371 | 1,591 | 5,440 | 5,358 | ||||||||||||
| Stock-based compensation expense | 5,260 | 2,514 | 13,965 | 10,213 | ||||||||||||
| Adjusted EBITDA | $ | (11,119 | ) | $ | (11,953 | ) | $ | (44,661 | ) | $ | (45,651 | ) | ||||
1 Gulati, et al. 2021 AHA/ACC/ASE/CHEST/SAEM/SCCT/SCMR Guideline for the Evaluation & Diagnosis of Chest Pain. J Am Coll Cardiol.
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