Heartflow, Inc. reported fourth‑quarter 2025 results on March 18, 2026, with total revenue of $49.1 million—an increase of 40% year‑over‑year. Non‑GAAP earnings per share were $‑0.12, beating consensus estimates of $‑0.15 and $‑0.17 by $0.03 and $0.05 respectively, and surpassing the $‑0.19 average estimate.
Revenue growth was driven by a 41% rise in U.S. revenue to $44.8 million and a 41% increase in overseas revenue to $4.3 million, while other revenue remained modest. The company’s gross margin expanded to nearly 80% from 75.3% in Q4 2024, a result of higher case volume and AI‑driven efficiencies that lowered production costs.
Management guidance for 2026 projects revenue of $218 million to $222 million, representing 24%–26% year‑over‑year growth. The company also raised its mid‑term non‑GAAP gross margin target to 85%, signaling confidence in continued profitability improvements.
"Our strong fourth‑quarter performance concluded a record year for Heartflow," said President and CEO John Farquhar. "The accelerating adoption of the Heartflow Platform, combined with our disciplined execution across commercial, innovation, and clinical initiatives, drove 40% fourth‑quarter and full‑year revenue growth and record gross margins."
CFO Vikram Verghese noted, "Total revenue for the fourth quarter was $49.1 million, up 40%. U.S. revenue grew to $44.8 million, up 41% and OUS and other revenue grew to $4.3 million."
Investors reacted cautiously to the 2026 revenue guidance, which was viewed as below market expectations, despite the strong quarterly performance. The guidance was perceived as a headwind, while the robust results and margin expansion were viewed as tailwinds.
Heartflow is advancing several strategic initiatives, including the launch of PCI Navigator in April 2026 and the introduction of HeartFlow Autonomous Processing later in the year. The company is also expanding into the high‑risk asymptomatic population, targeting a $6 billion U.S. market opportunity, and has secured Aetna coverage for Plaque Analysis, increasing U.S. covered lives to approximately 75%.
The company ended the quarter with $280.2 million in cash, equivalents, and investments, positioning it well to fund ongoing innovation and maintain operational flexibility amid the guidance‑related market concerns.
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