Heartflow (HTFL) Q1 2026 earnings summary

Executive summary

• Q1 2026 revenue reached $52.6 million, up 41% year-over-year, driven by 67% global case growth, strong U.S. FFRCT volume, and expanding Plaque Analysis adoption.

• Gross margin expanded to 80.5% non-GAAP (80.2% GAAP), up from 75.3% (75.1% GAAP) a year ago, reflecting higher case volume, AI-driven productivity, and automation.

• Net loss for Q1 2026 was $27.4 million GAAP ($0.32/share), including a $7.5 million non-cash impairment from headquarters relocation; non-GAAP net loss was $13.3 million ($0.16/share).

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

• The AI-powered platform now includes RoadMap, Plaque, FFRCT, and PCI Navigator, supporting deeper clinical integration and adoption.

Financial highlights

• Total Q1 revenue: $52.6 million (+41% YoY); U.S. revenue: $48.3 million (+42% YoY); OUS revenue: $4.3 million.

• Gross profit was $42.2 million, up from $27.9 million in the prior year period.

• Non-GAAP operating loss was $15.5 million; adjusted EBITDA was $(14.0) million.

• Operating expenses were $71.7 million in Q1 2026, including a $7.5 million asset impairment charge.

• Cash used in operating activities: $30.1 million in Q1 2026.

Outlook and guidance

• 2026 revenue guidance raised to $228–$232 million (29–32% YoY growth); Plaque revenue outlook increased to $19–$21 million.

• Full-year non-GAAP gross margin guidance raised to ~81%, up 400 bps YoY; midterm target remains 85%.

• Cash flow profitability expected by mid-2028.

• Management expects continued losses as the company invests in scaling operations, R&D, and commercial expansion.

• Anticipates launching Plaque Tracker in 2027.