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Heartflow, Inc., an AI-powered cardiovascular diagnostics company, has filed to go public on the Nasdaq Global Select Market under the ticker HTFL. The company plans to offer 16,666,667 shares of its common stock at an estimated price range of $17.00 to $18.00 per share, implying a deal size of approximately $291.7 million at the midpoint ($17.50). This would value Heartflow at a post-offer enterprise value of approximately $1.12 billion and a market cap of $1.42 billion. Lead underwriters include J.P. Morgan, Morgan Stanley, Piper Sandler, Stifel, and Canaccord Genuity.
Heartflow has developed a novel AI-driven software platform for the non-invasive diagnosis and management of coronary artery disease (CAD). The platform integrates deep learning and computational fluid dynamics to analyze a single coronary CT angiography (CCTA) scan, providing critical insights into blood flow, plaque burden, and stenosis severity. The company has already assessed more than 400,000 patients as of March 31, 2025 and holds the distinction of being the most widely adopted AI test for CAD.
Upon completion of the IPO, insiders (including executive officers, directors, and 5%+ owners) will own approximately 50.1% of the outstanding shares, assuming no overallotment or insider participation. Heartflow qualifies as an emerging growth company under the JOBS Act and will take advantage of reduced public company reporting requirements.
Offering Structure and Use of Proceeds
This is a traditional IPO. In addition to the base offering, underwriters have been granted a 30-day option to purchase up to 2,500,000 additional shares. Proceeds from the offering are expected to be used to repay approximately $50 million in debt under the company's 2024 Credit Agreement, with an additional $6.2 million in related fees. The remaining funds will support sales and marketing, R&D initiatives, general corporate purposes, and potentially strategic acquisitions, though no definitive M&A plans are in place.
The IPO will dilute existing shareholders but will also significantly strengthen Heartflow’s balance sheet, which reported $80.2 million in cash as of June 30, 2025, down from $109.8 million the prior quarter.
Business Description
Heartflow’s platform is designed to enhance the diagnostic power of CCTA scans by providing AI-driven assessments of blood flow and plaque composition. Its key commercial products include:
- Heartflow RoadMap Analysis – enhances efficiency and accuracy of CCTA review.
- Heartflow FFRCT Analysis – calculates fractional flow reserve to identify significant blockages (99% of 2025 Q1 revenue).
- Heartflow Plaque Analysis – assesses plaque volume and composition using AI (FDA cleared in 2022).
- Heartflow PCI Planner – a fourth product expected in 2026 for pre-procedure planning.
The platform is currently reimbursed under Category I CPT codes in the U.S., with strong backing from clinical guidelines by the AHA and ACC. International approvals are in place in the UK, EU, Canada, Japan, and the Middle East.
Company History
Heartflow was founded in 2007 and underwent a corporate reorganization in 2021, consolidating into its current form in July 2025. The company has not pursued major M&A to date but has raised significant private funding and convertible debt prior to the IPO.
Risk Factors
Key risks highlighted in the filing include:
- Continued dependence on a single core product (FFRCT Analysis).
- Uncertain adoption among healthcare providers.
- Regulatory hurdles and reimbursement pressures.
- Data security concerns and reliance on AI models.
- Concentration risk in its customer base and rapid cash burn.
Heartflow has demonstrated strong revenue growth over the past two years, with top-line revenue increasing from $87.2 million in 2023 to $125.8 million in 2024, marking a 44% year-over-year increase. In the first quarter of 2025, revenue reached $37.2 million, up 39% from $26.8 million in the same period of 2024. The company has steadily improved its gross margins, rising from 67% in 2023 to 75% in 2024, driven by increased automation and operational scale. While the company continues to operate at a loss, its operating losses narrowed in 2024 to $61.2 million, compared to $72.9 million in 2023. However, net losses have remained significant—$96.4 million in 2024 and $32.3 million in Q1 2025—reflecting continued investment in R&D and commercial expansion. These losses, while notable, are offset by encouraging signs of margin expansion and revenue acceleration, suggesting that Heartflow’s high-growth SaaS-style model may scale efficiently over time.
Growth Initiatives and Outlook
Heartflow plans to drive adoption of its Plaque Analysis product and eventually launch its PCI Planner in 2026. The company is investing in clinical studies to support expanded indications and reimbursement, and aims to broaden its international footprint. Automation of its “human-in-the-loop” review process is expected to yield future margin improvements.
Comparable Companies
Comparable firms in the digital health diagnostics space include:
- iRhythm Technologies (IRTC)
- Shockwave Medical (SWAV)
- Nanox Imaging (NNOX)
- Viz.ai (private, but often referenced)
- Heart Test Laboratories (HSCS)
Heartflow’s EV/Revenue multiple of ~9.5x (based on $125.8M revenue and $1.2B EV) puts it near the higher end of the peer range, reflecting strong clinical adoption and market leadership in AI for CAD.
Investor Sentiment and Strategic Implications
The IPO is expected to generate strong interest among institutional investors given Heartflow’s proven revenue model, high clinical validation, and strong backing from medical societies..
Post-IPO Strategy
Post-IPO, Heartflow aims to:
- Pay down debt to improve balance sheet health.
- Accelerate sales and marketing for Plaque Analysis.
- Expand clinical validation and reimbursement support.
- Launch PCI Planner in 2026.
- Explore potential acquisitions that complement its AI-enabled diagnostic platform.
Heartflow is expected to debut on Friday, August 8th, 2025