Our data suggest that despite the ability of CMA to mediate clearance of desmin in vitro in cardiomyocytes, in the in vivo model of ischemic HF, CMA is unable to clear phosphorylated desmin which forms aggregates, mainly detected in the insoluble protein fraction, suggesting the difficulty of the KFERQ motifs to be accessible to Hsc70 [44] but also the requirement of ubiquitination of proteins. Here, DES is linked to hydrops fetalis.