Tearsheet

HeartFlow (HTFL)


Market Price (12/29/2025): $29.83 | Market Cap: $1.5 Bil
Sector: Health Care | Industry: Health Care Technology

HeartFlow (HTFL)


Market Price (12/29/2025): $29.83
Market Cap: $1.5 Bil
Sector: Health Care
Industry: Health Care Technology

Investment Highlights Why It Matters Detailed financial logic regarding cash flow yields vs trend-riding momentum.


0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -18%
Weak multi-year price returns
2Y Excs Rtn is -42%, 3Y Excs Rtn is -78%
Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -62 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -39%
1 Megatrend and thematic drivers
Megatrends include Biotechnology & Genomics, Precision Medicine, and Digital Health & Telemedicine. Themes include Advanced Diagnostics, Show more.
  Not cash flow generative
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is -35%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is -38%
2   Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -13%
3   Key risks
HTFL key risks include [1] a history of significant operating losses and [2] heavy revenue dependence on its single FFRCT Analysis product.
0 Cash is significant % of market cap
Net D/ENet Debt/Equity. Debt net of cash. Negative indicates net cash. Equity is taken as the Market Capitalization is -18%
1 Megatrend and thematic drivers
Megatrends include Biotechnology & Genomics, Precision Medicine, and Digital Health & Telemedicine. Themes include Advanced Diagnostics, Show more.
2 Weak multi-year price returns
2Y Excs Rtn is -42%, 3Y Excs Rtn is -78%
3 Not profitable at operating income level
Op Inc LTMOperating Income, Last Twelve Months is -62 Mil, Op Mgn LTMOperating Margin = Operating Income / Revenue Reflects profitability before taxes and before impact of capital structure (interest payments). is -39%
4 Not cash flow generative
CFO/Rev LTMCash Flow from Operations / Revenue (Sales), Last Twelve Months (LTM) is -35%, FCF/Rev LTMFree Cash Flow / Revenue (Sales), Last Twelve Months (LTM) is -38%
5 Yield minus risk free rate is negative
ERPEquity Risk Premium (ERP) = Total Yield - Risk Free Rate, Reflects the premium above risk free assets offered by the investment. is -13%
6 Key risks
HTFL key risks include [1] a history of significant operating losses and [2] heavy revenue dependence on its single FFRCT Analysis product.

Valuation, Metrics & Events

HTFL Stock


Why The Stock Moved


Qualitative Assessment

AI Analysis | Feedback

Here are five key points explaining the approximate -5.3% stock movement for HeartFlow (HTFL) during the period from August 31, 2025, to December 29, 2025:

1. 1. Disappointing Q3 2025 Net Loss: HeartFlow reported a significant net loss of $50.9 million in the third quarter of 2025, a substantial increase compared to the $19.1 million loss in the prior year. This substantial increase in losses contributed to Wall Street's concerns about the company's financial health, overshadowing strong revenue growth. This specific earnings report led to a 6.3% tumble in the stock's after-hours trading on November 12, 2025.

2. 2. Lack of Operating Leverage: Despite a robust 41% year-over-year increase in revenue in Q3 2025, HeartFlow's GAAP operating losses remained relatively flat at $15.1 million. This indicated that revenue growth was not translating into significant improvements in operating profitability, which is a concern for investors.

3. Show more

Stock Movement Drivers

Fundamental Drivers

The -9.8% change in HTFL stock from 9/28/2025 to 12/28/2025 was primarily driven by a 0.0% change in the company's Shares Outstanding (Mil).
928202512282025Change
Stock Price ($)33.0629.83-9.77%
Change Contribution ByLTMLTM
Total Revenues ($ Mil)
Net Income Margin (%)
P/E Multiple
Shares Outstanding (Mil)63.8663.860.00%
Cumulative Contribution

LTM = Last Twelve Months as of date shown

Market Drivers

9/28/2025 to 12/28/2025
ReturnCorrelation
HTFL-9.8% 
Market (SPY)4.3%31.3%
Sector (XLV)15.2%38.1%

Fundamental Drivers

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Market Drivers

6/29/2025 to 12/28/2025
ReturnCorrelation
HTFL  
Market (SPY)12.6%24.6%
Sector (XLV)17.0%27.0%

Fundamental Drivers

null
null

Market Drivers

12/28/2024 to 12/28/2025
ReturnCorrelation
HTFL  
Market (SPY)17.0%24.6%
Sector (XLV)13.8%27.0%

Fundamental Drivers

null
null

Market Drivers

12/29/2023 to 12/28/2025
ReturnCorrelation
HTFL  
Market (SPY)48.4%24.6%
Sector (XLV)17.8%27.0%

Return vs. Risk


Price Returns Compared

 202020212022202320242025Total [1]
Returns
HTFL Return-----6%6%
Peers Return16%38%-12%21%26%16%150%
S&P 500 Return16%27%-19%24%23%18%114%

Monthly Win Rates [3]
HTFL Win Rate-----60% 
Peers Win Rate52%65%42%68%57%52% 
S&P 500 Win Rate58%75%42%67%75%73% 

Max Drawdowns [4]
HTFL Max Drawdown------11% 
Peers Max Drawdown-34%-5%-26%-7%-9%-23% 
S&P 500 Max Drawdown-31%-1%-25%-1%-2%-15% 


[1] Cumulative total returns since the beginning of 2020
[2] Peers: HPQ, HPE, IBM, CSCO, AAPL.
[3] Win Rate = % of calendar months in which monthly returns were positive
[4] Max drawdown represents maximum peak-to-trough decline within a year
[5] 2025 data is for the year up to 12/26/2025 (YTD)

How Low Can It Go

HTFL has limited trading history. Below is the Health Care sector ETF (XLV) in its place.

Unique KeyEventXLVS&P 500
2022 Inflation Shock2022 Inflation Shock  
2022 Inflation Shock% Loss% Loss-16.1%-25.4%
2022 Inflation Shock% Gain to Breakeven% Gain to Breakeven19.1%34.1%
2022 Inflation ShockTime to BreakevenTime to Breakeven599 days464 days
2020 Covid Pandemic2020 Covid Pandemic  
2020 Covid Pandemic% Loss% Loss-28.8%-33.9%
2020 Covid Pandemic% Gain to Breakeven% Gain to Breakeven40.4%51.3%
2020 Covid PandemicTime to BreakevenTime to Breakeven116 days148 days
2018 Correction2018 Correction  
2018 Correction% Loss% Loss-15.8%-19.8%
2018 Correction% Gain to Breakeven% Gain to Breakeven18.8%24.7%
2018 CorrectionTime to BreakevenTime to Breakeven326 days120 days
2008 Global Financial Crisis2008 Global Financial Crisis  
2008 Global Financial Crisis% Loss% Loss-40.6%-56.8%
2008 Global Financial Crisis% Gain to Breakeven% Gain to Breakeven68.3%131.3%
2008 Global Financial CrisisTime to BreakevenTime to Breakeven1,100 days1,480 days

Compare to HPQ, HPE, IBM, CSCO, AAPL

In The Past

SPDR Select Sector Fund's stock fell -16.1% during the 2022 Inflation Shock from a high on 4/8/2022. A -16.1% loss requires a 19.1% gain to breakeven.

Preserve Wealth

Limiting losses and compounding gains is essential to preserving wealth over time.

Asset Allocation

Actively managed asset allocation strategies protect wealth. Learn more.

About HeartFlow (HTFL)

We have pioneered the use of software and AI to deliver a more accurate and clinically effective non-invasive solution for diagnosing and managing coronary artery disease (“CAD”), a leading cause of death worldwide. As of March 31, 2025, our Heartflow Platform has been used to assess CAD in more than 400,000 patients, including 132,000 in 2024 alone. We believe that we are the most widely adopted AI-powered test for CAD. Our novel platform leverages AI and advanced computational fluid dynamics to create a personalized 3D model of a patient’s heart from a single coronary computed tomography angiography (“CCTA”), a specialized type of scan that provides detailed images of the heart’s arteries. Our Heartflow Platform delivers actionable insights on blood flow, stenosis, plaque volume and plaque composition thereby overcoming the limitations of traditional non-invasive imaging tests which rely on indirect measures of coronary disease and lead to higher false negative and false positive rates, as demonstrated by our PRECISE trial. We believe the differentiated accuracy and clinical utility of our Heartflow Platform, along with its ability to enhance workflows, will continue to support our growth and advance the “CCTA + Heartflow” pathway as the definitive standard for the non-invasive diagnosis and management of CAD. Cardiovascular disease is the leading cause of death worldwide, with CAD being the most lethal form. CAD occurs when plaque—a buildup of cholesterol, fat, calcium and other substances—accumulates on the walls of the coronary arteries, restricting blood flow and increasing the risk of heart attack or stroke. This condition is responsible for half of all cardiovascular-related deaths globally. In the United States alone, the Centers for Disease Control (“CDC”) estimates that approximately 805,000 people suffer a heart attack each year. Despite significant advancements in therapeutic and interventional treatments, CAD remains a leading cause of death globally because healthcare systems generally lack scalable methods to efficiently detect, diagnose and quantify CAD at a personalized level. Based on our analyses using Clarivate’s ProcedureFinder data repository, we estimate that there were approximately 9.5 million non-invasive tests (“NITs”) in the United States in 2023 for patients experiencing stable or acute chest pain, which we refer to as symptomatic CAD patients. These NITs primarily include stress tests, such as single-photon emission computed tomography (“SPECT”), echocardiography and positron emission tomography (“PET”), which infer the presence of heart disease based on how well blood is supplied to the heart, and do not measure the actual disease itself. Accordingly, these tests have been shown to be unreliable and inconsistent. CCTA has emerged as a leading non-invasive imaging method for evaluating CAD, offering direct and detailed visualization of the coronary arteries. Unlike traditional stress-based NITs, CCTA enables physicians to identify the presence and extent of coronary blockage. As a result, CCTA has become the preferred first-line test for patients with suspected CAD, as evidenced by the AHA and ACC guidelines elevating CCTA to Class 1, Level A. However, while CCTA provides superior anatomical imaging, it does not independently quantify the severity of CAD, assess blood flow limitations, or characterize plaque composition—critical factors for determining the most appropriate, personalized course of treatment for a patient. Our Heartflow Platform builds upon the well established strengths of CCTA by going beyond its limitations and providing new quantified insights and compelling visualizations of data. By applying our advanced AI- powered technology to a single CCTA scan, we generate a precise, patient-specific analysis that quantifies blood flow, measures plaque burden, and characterizes plaque composition—at every point in the major coronary arteries. To date, we have developed three software products (with a fourth product expected to launch in 2026) under the Heartflow Platform that provide physicians with the critical insights needed to effectively diagnose and manage CAD: • Heartflow RoadMap Analysis offers a highly intuitive anatomic visualization of the coronary arteries, helping physicians quickly identify clinically relevant areas to focus their review. We provide Heartflow RoadMap Analysis to accounts as an integrated feature to enhance the efficiency of their CCTA program and it is not a stand-alone product. • Heartflow FFRCT Analysis calculates blood flow and pinpoints clinically significant CAD, which is CAD with a fractional flow reserve (“FFR”) value of 0.80 or below, at every point in the major coronary arteries. FFR measures the severity of blood flow restriction in the coronary arteries on a scale of 1.0 (no restriction) to 0.0 (complete blockage) by assessing pressure differences across a stenosis during induced stress, guiding decisions on whether a patient requires invasive revascularization. • Heartflow Plaque Analysis provides a comprehensive assessment of coronary plaque, enabling optimized medical treatment strategies. • Heartflow PCI Planner, which we expect to launch in 2026, will provide advanced visualization and clinical insights to optimize revascularization strategies, guide device selection, enhance procedural efficiency, and improve patient care. We plan to provide Heartflow PCI Planner to accounts as an integrated feature to enhance procedural efficiency, not as a stand-alone product. We believe we are the first and most widely-adopted AI-powered test for CAD. With over a decade of commercial presence, we have established a competitively differentiated data set of approximately 110 million annotated images, which is primarily sourced from our commercial relationships with customers, driving training and refinement of our algorithms for over 10 years and the ability to train new AI models for future products. We believe our Heartflow Platform delivers the following key benefits: • More accurate non-invasive test for CAD, clinically validated to provide superior assessment of blood flow, plaque volume and plaque characterization compared to traditional non-invasive methods. • More informed assessments, personalized care, and better risk stratification, positively impacting physician decisions on which patients should receive an intervention, supporting more efficient intervention planning and driving more personalized medical management. • Superior economic efficiency and enhanced interventional treatment planning, accurately identifying more patients who need interventional treatment while reducing unnecessary invasive procedures—significantly improving the efficiency of the catheterization lab and therefore hospital economics. • Proprietary, secure bi-directional data communication with customers that feeds a growing database of approximately 110 million annotated CCTA images that we leverage to improve the Heartflow Platform’s accuracy, automation and clinical utility and seamlessly deliver new features and workflow efficiencies to our customers. • Improved workflow through our Heartflow RoadMap Analysis that, as demonstrated in our SMART- CT study, reduces CCTA interpretation times by approximately 25% and reduces variability between reviewing physicians by approximately 40%, leading to more consistent diagnoses and standardized patient care. • Better patient and provider experience, by leveraging a single CCTA for all of our products, patients complete their test in approximately 20 minutes with significantly lower radiation exposure compared to nuclear imaging tests such as SPECT and PET that take multiple hours and require radioactive tracers to be injected into the bloodstream. By providing a definitive diagnosis upfront, the Heartflow Platform eliminates the need for layered testing, streamlining the patient journey and reducing anxiety associated with uncertain or inconclusive results. We estimate our current market opportunity in the United States for our Heartflow FFRCT Analysis and Heartflow Plaque Analysis is approximately $5 billion. Based on our analyses using Clarivate’s ProcedureFinder data repository, we estimate that approximately 9.5 million unique stable chest pain patients receive NITs in the United States annually. In addition, based on our FORECAST randomized trial, we further estimate that 33% of patients have stenosis levels between 40% and 90%, which results in approximately 2.8 million patients eligible for our Heartflow FFRCT Analysis in the stable setting. Based on the Martin paper, where there were approximately 577,000 hospital discharges in the United States in 2020 due to a principal diagnosis of acute chest pain, and the Bhatt paper, where No ST Elevation (“NSTE”) related acute chest pain accounted for approximately 70% of acute chest pain, we further estimate that the annual incidence of patients who have acute chest pain with NSTE is approximately 0.4 million patients. Of these approximately 0.4 million patients, we estimate based on the Kofoed paper that approximately 70% have obstructive disease and are eligible for our Heartflow FFRCT Analysis, which results in approximately 0.3 million acute chest pain patients eligible for our Heartflow FFRCT Analysis. Therefore, we believe there is a market opportunity of approximately 3.1 million patients eligible for our Heartflow FFRCT Analysis, which, at a U.S. average sales price of $1,067, translates to an estimated market opportunity of approximately $3.3 billion in the United States. In addition, we believe our Heartflow Plaque Analysis is applicable to approximately 60% of those 9.5 million NIT patients annually and the majority of patients experiencing acute chest pain. Based on our PROMISE trial and the Hoffmann paper, we estimate that approximately 60% of CCTA patients have plaque and are eligible for plaque analysis, which translates to approximately 5.1 million patients eligible for our Heartflow Plaque Analysis in a stable setting. Based on our internal analysis and the findings in the Wang paper, where less than 5% of patients were expected to be contraindicated for CCTA, we also estimate that all of the approximately 0.4 million patients with acute chest pain with NSTE referred to above will be eligible for our Heartflow Plaque Analysis. Therefore, we believe there is a market opportunity of approximately 5.5 million patients eligible for our Heartflow Plaque Analysis, which, at an estimated U.S. sales price of $300, translates to an estimated market opportunity of approximately an incremental $1.7 billion in the United States. Beyond the commercialization of Heartflow FFRCT Analysis and Heartflow Plaque Analysis in symptomatic CAD, we see a significant market opportunity for our technologies in at-risk individuals who show no symptoms, a segment comprised of approximately 200 million people globally, based on data from the U.S. Census Bureau, CDC, Eurostat, United Kingdom Office of National Statistics, the Yang paper and the MacDonald paper. To unlock this potential, we are continuing to evaluate new product opportunities and appropriate clinical evidence supporting eventual regulatory approval, payor coverage and commercialization. We believe the Heartflow Platform is the most extensively studied AI-enabled test for CAD. Our belief is grounded in our analysis, including that the Heartflow Platform and its accuracy, clinical utility and economic benefits have been evaluated in over 100 clinical studies and more than 130,000 patients, including our PRECISE and FORECAST trials, each a large randomized controlled trial, with results published in over 600 peer-reviewed clinical publications. Our studies, including the PRECISE, NXT and PACIFIC trials, have consistently demonstrated that the Heartflow Platform is more accurate than traditional non-invasive tests and highly concordant to invasive testing, reduces unnecessary invasive testing, and enables physicians to optimize treatment and ultimately provide more efficient care. We have developed a highly scalable, capital efficient commercial model that combines Territory Sales Managers (“TSMs”) who drive new account adoption with Territory Account Managers (“TAMs”) who focus on increasing utilization by educating referring physicians. Our commercial team does not cover cases or otherwise spend time in an operating room or lab setting, which enables them to focus solely on driving commercial adoption and educational activities. Our technology is simple and intuitive and does not require the purchase of any capital equipment. Our onboarding process seamlessly integrates the Heartflow Platform into the customer’s daily workflow. These unique attributes of our business model afford our commercial organization a differentiated level of efficiency and scalability. Current clinical guidelines strongly support the adoption of the Heartflow Platform. The CCTA + Heartflow FFRCT Analysis pathway is supported by the American Heart Association (“AHA”) and American College of Cardiology (“ACC”) guidelines, with CCTA identified as a Class 1, Level A test and Heartflow FFRCT Analysis identified as a Class 2a, Level B test for the diagnosis of CAD in certain patients with stable or acute chest pain and no known CAD. The AHA and ACC guidelines utilize Classes and Levels to indicate the strength of a recommendation and the quality of supporting evidence, respectively. Class 1 represents the strongest recommendation, followed by Class 2a, which represents a moderate recommendation. Similarly, Level A signifies the highest quality of evidence, while Level B indicates moderate quality. We believe current reimbursement policies support the adoption of the Heartflow Platform. Our Heartflow FFRCT Analysis is reimbursed under a dedicated Category I Current Procedural Terminology (“CPT”) code, effective as of January 1, 2024, and has established coverage policies representing approximately 99% of covered lives in the United States. A Category I CPT code was recently established for Heartflow Plaque Analysis. It will go into effect on January 1, 2026, and is covered by all seven Medicare administrative contractor (“MACs”). A Category I CPT code designates a procedure or service that uses device(s) with Food and Drug Administration (“FDA”) clearance or approval (when required), is performed by many physicians across the United States for its intended clinical use, aligns with current medical practice,and has documented efficacy in literature. The Category I CPT status for our Heartflow FFRCT Analysis and Heartflow Plaque Analysis validates their widespread use and distinguish them from emerging technologies that are assigned Category III CPT codes. We primarily generate revenue on a “pay-per-click” basis each time a physician chooses to review either our Heartflow FFRCT Analysis, Heartflow Plaque Analysis, or both. Heartflow FFRCT Analysis has served as our commercial foundation, representing 99% of our total revenue as of March 31, 2025. In the second half of 2023, we initiated limited market education efforts for Heartflow Plaque Analysis, our second commercial product. Our Heartflow RoadMap Analysis is generally provided as a workflow efficiency tool to drive customer retention and loyalty and is not a stand-alone product. We expect to launch our next product, Heartflow PCI Planner, in 2026 as an integrated feature to enhance procedural efficiency, not as a stand-alone product. We were incorporated under the laws of the State of Delaware in 2007. On March 1, 2021, we completed an internal reorganization in which a newly formed parent holding company was put in place. Our operations and business activities remained at HeartFlow, Inc., and the wholly-owned non-U.S. subsidiaries of HeartFlow, Inc. remained in place. On July 17, 2025, we consolidated HeartFlow Holding, Inc. into HeartFlow, Inc. In connection with this consolidation, we changed our name to Heartflow, Inc., whose name appears on the cover of this prospectus. Our principal executive offices are located in Mountain View, California.

AI Analysis | Feedback

Here are 1-3 brief analogies to describe HeartFlow (HTFL):

  • Exact Sciences for heart disease diagnosis: Like Exact Sciences provides a non-invasive stool test (Cologuard) for colon cancer screening, HeartFlow offers a non-invasive way to diagnose coronary artery disease using advanced CT scan analysis, aiming to reduce the need for invasive procedures.
  • Palantir for heart health insights: HeartFlow uses sophisticated AI and computational models to extract critical, actionable insights from complex medical imaging data, similar to how Palantir applies advanced data analytics to solve high-stakes problems for governments and large enterprises.
  • Google's AI for heart scans: HeartFlow leverages cutting-edge artificial intelligence and computational fluid dynamics to provide detailed, functional assessments of coronary arteries from standard CT scans, akin to how Google's AI initiatives aim to enhance medical image analysis and diagnostics.

AI Analysis | Feedback

  • HeartFlow FFRct Analysis: This diagnostic medical technology service non-invasively assesses coronary artery disease by analyzing CT scans to create a 3D model and measure blood flow, helping physicians determine the functional impact of blockages.

AI Analysis | Feedback

HeartFlow (symbol: HTFL) was a public company that delisted from Nasdaq in February 2024. During its time as a public company, HeartFlow primarily sold its HeartFlow FFRct Analysis to other companies within the healthcare sector, rather than directly to individuals.

HeartFlow's public filings (e.g., 10-K reports) did not identify specific individual customers that accounted for 10% or more of its revenue. Therefore, no single "major customer" company by name, with a corresponding public stock symbol, was disclosed.

Instead, HeartFlow's customer base consisted of a diversified range of healthcare providers. The major categories of these customer organizations were:

  • Hospitals
  • Integrated Delivery Networks (IDNs)
  • Large Cardiology Practices

These customer organizations are typically private or non-profit entities, and their specific names were not publicly disclosed as major individual customers by HeartFlow.

AI Analysis | Feedback

  • Amazon Web Services (AWS) (Symbol: AMZN)
  • Google Cloud Platform (GCP) (Symbol: GOOGL)

AI Analysis | Feedback

John Farquhar, President, Chief Executive Officer, and Member of the Board of Directors

John Farquhar joined HeartFlow in August 2021 as Chief Operating Officer and was appointed President and Chief Executive Officer on March 1, 2022. He brings over 20 years of medtech leadership experience. Prior to HeartFlow, he held several leadership roles at Medtronic, including Vice President and General Manager of the Aortic business (2015-2020), and Vice President for the Americas region for the Insulin Pump and Continuous Glucose Monitoring business unit (2010-2015). He also served as a Marketing Manager at General Mills from 2003 to 2008.

Vikram Verghese, Chief Financial Officer

Vikram Verghese joined HeartFlow in 2021 and has held leadership roles in Business Development, Strategy, and Product Management within the company. His prior experience includes senior roles at Medtronic and Verily Life Sciences, with expertise in global marketing, regulatory and clinical affairs, business development, and cross-functional operations.

Campbell Rogers, M.D., F.A.C.C., Executive Vice President and Chief Medical Officer

Campbell Rogers brings a wealth of experience to HeartFlow. Prior to joining HeartFlow, he served as the Chief Scientific Officer and Global Head of Research and Development at Cordis Corporation, Johnson & Johnson, where he was responsible for leading investments and research in cardiovascular devices. Before his time at Cordis, Dr. Rogers was an Associate Professor of Medicine at Harvard Medical School and the Harvard-M.I.T. Division of Health Sciences and Technology, and Director of the Cardiac Catheterization and Experimental Cardiovascular Interventional Laboratories at Brigham and Women's Hospital.

Angela Ahmad, Chief Legal & Compliance Officer

Angela Ahmad brings over 25 years of public company and medtech legal and compliance experience to HeartFlow. Most recently, she served as the General Counsel, Chief Compliance Officer, and Corporate Secretary of Inari Medical, Inc.

AI Analysis | Feedback

HeartFlow (HTFL) faces several key business risks, primarily stemming from its financial performance, intense market competition, and reliance on reimbursement policies.

  1. Achieving and Sustaining Profitability and Product Concentration: HeartFlow has a history of significant operating losses and negative free cash flow, and management has warned of "substantial losses in the foreseeable future". The company's business has been heavily reliant on its HeartFlow FFRCT Analysis product for virtually all its revenue, though it is working to commercialize its second product, HeartFlow Plaque Analysis. While funding and revenue growth have been noted, the path to sustained profitability and diversification beyond its core offering remains a significant challenge.
  2. Intense Market Competition and Technological Disruption: The cardiac imaging and diagnostics market is highly competitive, with a mix of established medical technology companies such as Siemens Healthineers, GE Healthcare, and Philips, as well as a growing number of emerging AI-driven firms like Cleerly, CathWorks, and Elucid. These competitors are developing similar or potentially disruptive technologies, which could affect HeartFlow's market share and lead to pricing pressures. Rapid advancements in AI and medical imaging necessitate continuous research and development investment to avoid technological obsolescence.
  3. Reliance on Reimbursement Policies and Adoption Challenges: HeartFlow's revenue is directly impacted by reimbursement rates and coverage decisions from third-party payers, including government programs like Medicare and private insurers. Reductions in these rates or changes in policies could significantly affect the financial viability and adoption of HeartFlow's technology. Additionally, widespread adoption faces hurdles due to varying healthcare systems and the willingness of physicians to change established practices. While there have been positive developments in reimbursement, the ongoing dependence on these policies remains a crucial risk factor.

AI Analysis | Feedback

The emergence of artificial intelligence (AI)-powered platforms that provide comprehensive analysis of standard computed tomography coronary angiography (CCTA) scans for the diagnosis and management of coronary artery disease (CAD). These platforms, exemplified by companies like Cleerly, aim to deliver detailed information on plaque characteristics, stenosis severity, and functional significance directly from CCTA data, potentially reducing the incremental need for HeartFlow's specialized FFRct analysis. By offering a more integrated and comprehensive diagnostic solution from a single CCTA, these AI-driven approaches represent a direct alternative that could diminish the market demand for HeartFlow's specific technology.

AI Analysis | Feedback

HeartFlow (HTFL) estimates the addressable market for its primary products and services to be approximately $5 billion, primarily within the U.S. market.

  • The estimated market opportunity for its HeartFlow FFRCT Analysis is $3.3 billion.
  • The HeartFlow Plaque Analysis has an estimated incremental market opportunity of $1.7 billion.

The company notes that its FFRCT Analysis is covered by 99% of U.S. payers. HeartFlow also aims to expand its total addressable market from an estimated $10 billion to over $50 billion through new product introductions and increased utilization in existing healthcare systems.

AI Analysis | Feedback

HeartFlow (HTFL) is anticipated to drive future revenue growth over the next 2-3 years through several key factors:

  • Increased Adoption and Utilization of the HeartFlow Platform: The company expects revenue growth from expanding its installed customer base and increasing the utilization of its system by existing accounts. HeartFlow reported over 1,100 customer accounts at the end of 2024.
  • Commercialization and Growth of Recently Launched Products: HeartFlow recently introduced the next-generation HeartFlow Plaque Analysis Platform (September 2025) and the HeartFlow PCI Navigator (October 2025). The HeartFlow Plaque Analysis is estimated to have a market opportunity of approximately 5.5 million patients, representing an incremental market opportunity of $1.7 billion.
  • Favorable Reimbursement and Expanding Payer Coverage: The HeartFlow FFRct Analysis is reimbursed under a dedicated Category I CPT code, effective January 1, 2024, with coverage policies representing about 99% of covered lives in the U.S. A Category I CPT code for HeartFlow Plaque Analysis will become effective on January 1, 2026, and is expected to be covered by all seven major payers. This expanding reimbursement for newer products, as evidenced by Cigna Health Plans covering AI-powered HeartFlow Plaque Analysis, is a significant driver.
  • Addressing a Large and Growing Market Opportunity: HeartFlow estimates a current U.S. market opportunity of approximately $5 billion for its FFRct Analysis and Plaque Analysis systems. This growth is partly attributed to an aging global population and the prevalence of chronic diseases.

AI Analysis | Feedback

Share Issuance

  • HeartFlow completed its initial public offering (IPO) on August 11, 2025, issuing 19,166,667 shares of common stock at $19 per share.
  • The total gross proceeds from this offering amounted to approximately $364.2 million, which included the full exercise of the underwriters' option to purchase an additional 2,500,000 shares.

Inbound Investments

  • In April 2023, HeartFlow Holdings, Inc., the parent company, closed a $215 million Series F funding round, led by Bain Capital Life Sciences.
  • In March 2025, HeartFlow Holding, Inc. completed approximately $98 million in convertible notes financing, with investments from Fidelity Management & Research Company and existing investors.
  • The company raised approximately $364.2 million in gross proceeds from its initial public offering in August 2025.

Capital Expenditures

  • In the 12 months leading up to recent financial disclosures (around the IPO period in 2025), HeartFlow reported capital expenditures of -$3.24 million.
  • A portion of the net proceeds from the August 2025 IPO may be used for capital expenditures, as well as to acquire complementary businesses, products, services, or technologies, although no current understandings or commitments for such acquisitions exist.

Latest Trefis Analyses

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Peer Comparisons for HeartFlow

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Financials

HTFLHPQHPEIBMCSCOAAPLMedian
NameHeartFlowHP Hewlett .Internat.Cisco Sy.Apple  
Mkt Price29.8323.2624.49305.0978.16273.4053.99
Mkt Cap1.521.932.6284.9309.24,074.4158.8
Rev LTM16255,29534,29665,40257,696408,62556,496
Op Inc LTM-623,6241,64411,54412,991130,2147,584
FCF LTM-612,80062711,85412,73396,1847,327
FCF 3Y Avg-2,9781,40011,75313,879100,50311,753
CFO LTM-573,6972,91913,48313,744108,5658,590
CFO 3Y Avg-3,6723,89613,49814,736111,55913,498

Growth & Margins

HTFLHPQHPEIBMCSCOAAPLMedian
NameHeartFlowHP Hewlett .Internat.Cisco Sy.Apple  
Rev Chg LTM-3.2%13.8%4.5%8.9%6.0%6.0%
Rev Chg 3Y Avg--3.9%6.5%2.6%3.7%1.8%2.6%
Rev Chg Q40.5%4.2%14.4%9.1%7.5%9.6%9.4%
QoQ Delta Rev Chg LTM9.0%1.1%3.7%2.1%1.8%2.1%2.1%
Op Mgn LTM-38.5%6.6%4.8%17.7%22.5%31.9%12.1%
Op Mgn 3Y Avg-7.4%7.2%16.4%24.2%30.8%16.4%
QoQ Delta Op Mgn LTM3.3%-0.2%-1.4%0.6%0.4%0.1%0.2%
CFO/Rev LTM-35.5%6.7%8.5%20.6%23.8%26.6%14.6%
CFO/Rev 3Y Avg-6.8%12.7%21.4%26.1%28.4%21.4%
FCF/Rev LTM-37.6%5.1%1.8%18.1%22.1%23.5%11.6%
FCF/Rev 3Y Avg-5.5%4.6%18.6%24.6%25.6%18.6%

Valuation

HTFLHPQHPEIBMCSCOAAPLMedian
NameHeartFlowHP Hewlett .Internat.Cisco Sy.Apple  
Mkt Cap1.521.932.6284.9309.24,074.4158.8
P/S9.00.41.04.45.410.04.9
P/EBIT-14.06.819.925.122.531.321.2
P/E-11.78.6572.736.029.941.033.0
P/CFO-25.55.911.221.122.537.516.2
Total Yield-8.6%14.1%2.3%5.0%5.4%2.8%3.9%
Dividend Yield0.0%2.5%2.1%2.2%2.1%0.4%2.1%
FCF Yield 3Y Avg-10.6%5.5%6.4%6.0%3.1%6.0%
D/E0.00.50.70.20.10.00.2
Net D/E-0.20.30.60.20.00.00.1

Returns

HTFLHPQHPEIBMCSCOAAPLMedian
NameHeartFlowHP Hewlett .Internat.Cisco Sy.Apple  
1M Rtn-7.5%-3.6%12.7%-1.1%1.6%-2.0%-1.5%
3M Rtn-9.8%-11.9%2.7%7.9%17.0%7.1%4.9%
6M Rtn3.8%-4.0%34.5%6.6%15.2%36.3%10.9%
12M Rtn3.8%-27.0%16.2%40.5%34.5%7.5%11.8%
3Y Rtn3.8%-3.7%67.3%141.3%79.6%114.1%73.5%
1M Excs Rtn-10.6%-5.6%12.9%-2.2%-0.0%-3.7%-3.0%
3M Excs Rtn-14.1%-16.2%-1.7%3.6%12.7%2.8%0.6%
6M Excs Rtn-8.5%-16.3%22.3%-5.7%3.0%24.0%-1.3%
12M Excs Rtn-12.2%-42.9%-0.7%25.0%19.9%-8.4%-4.6%
3Y Excs Rtn-77.6%-83.5%-11.2%59.6%-1.2%28.4%-6.2%

Financials

Segment Financials

Revenue by Segment
$ Mil2024
Non-invasive coronary artery disease (CAD) detection solutions87
Total87


Operating Income by Segment
$ Mil2024
Non-invasive coronary artery disease (CAD) detection solutions-73
Total-73


Net Income by Segment
$ Mil2024
Non-invasive coronary artery disease (CAD) detection solutions-96
Total-96


Short Interest

Short Interest: As Of Date12152025
Short Interest: Shares Quantity1,448,787
Short Interest: % Change Since 1130202518.8%
Average Daily Volume503,079
Days-to-Cover Short Interest2.88
Basic Shares Quantity49,106,752
Short % of Basic Shares3.0%

Earnings Returns History

Expand for More
 Forward Returns
Earnings Date1D Returns5D Returns21D Returns
11/12/2025-13.4%-23.8%-28.3%
SUMMARY STATS   
# Positive000
# Negative111
Median Positive   
Median Negative-13.4%-23.8%-28.3%
Max Positive   
Max Negative-13.4%-23.8%-28.3%

SEC Filings

Expand for More
Report DateFiling DateFiling
93020251112202510-Q 9/30/2025
6302025919202510-Q 6/30/2025
123120248082025424B4 12/31/2024