HeartFlow Beats Earnings Expectations But Stock Falls 8% on Weak Guidance

LootboxPhobia · 2026-03-18T21:59:09+00:00

Heartflow, Inc. reported fourth-quarter earnings that exceeded expectations, but its 2026 revenue guidance disappointed the market, causing the stock to plunge 7.6%. Fourth-quarter loss per share was $0.12, with revenue up 40% year-over-year. The company expects 2026 revenue to grow 24%-26%.

LootboxPhobia

2026-03-18 21:59:09

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Investing.com – Heartflow, Inc. (NASDAQ:HTFL) announced its Q4 earnings exceeded analyst expectations, but the company’s 2026 revenue guidance disappointed investors, causing the stock to plummet 7.6% in after-hours trading on Wednesday.

The AI-based coronary artery disease diagnosis company reported a Q4 adjusted loss of $0.12 per share, better than the consensus estimate of a $0.15 loss. Revenue reached $49.1 million, up 40% year-over-year from $35.1 million. However, the company’s 2026 revenue guidance of $218 million to $222 million, with a midpoint of $220 million, seemed to fall short of market expectations.

Heartflow President and CEO John Farquhar said, “Our strong Q4 performance caps off a record-breaking year. The rapid adoption of the Heartflow platform, combined with our disciplined execution in commercial, innovation, and clinical initiatives, drove 40% revenue growth for the quarter and the full year, with gross margin reaching an all-time high.”

The company’s adjusted gross margin for the quarter expanded from 75.3% last year to 79.9%, driven by increased case volume and productivity improvements from AI efficiency initiatives. As of December 31, 2025, the number of installed U.S. customers increased to 1,465, with 489 U.S. Plaque installed customers. Aetna began underwriting Heartflow Plaque Analysis this quarter, bringing the number of insured Plaque cases in the U.S. to about 75%.

For fiscal 2026, the company expects revenue to grow approximately 24% to 26% year-over-year, with an adjusted gross margin of 80% to 81%. For fiscal 2025, total revenue was $176 million, a 40% increase year-over-year.

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