Pathophysiology of Aortic Stenosis. The initiating event is believed to be caused by mechanical damage to the cells lining the valve in a process similar to that which occurs in atherosclerosis. However the propagating mechanism is more likely to be that of active calcification. In support of this, a growing body of pre-clinical and clinical data indicates that treatments for osteoporosis, which work by preventing the breakdown of bone and therefore calcium release into the blood, can reduce calcium deposition (calcification) of the blood vessels. These agents therefore hold considerable promise as novel therapies for aortic stenosis.